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2100 - R Dependable Construction, Inc. - Rosemead Park Restroom Renovation Project (C24102)EMI]1l This page is part of your document - DO NOT DISCARD lyof Los w 20230344487 QIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIilllllllllll � { Recorded/Filed in Official Records It { Recorder's Office, Los Angeles County, California 05/26/23 AT 09:29AM LEADSHEET 202305262850008 00023470713 111111 BVI IYII IYII 1111111111 IYII IIIII IIIII 11111111 014088777 SEQ: 01 DAR - Mail (Intake) 111111 IIIVI IIII IIIII IIII IIIV IIIII IIIII VI VIYI IIIV 111111 VII IIII lVlll IIIII IIIY IIYI IIY VII VIII I�VI IIIII IIII YIII IIII 1111111 IIII VVII IVI IV1 IVVI IIII IIIII YIN IIIII VIII 1111111 VII THIS FORM IS NOT TO BE DUPLICATED FEES: TAXES: OTHER: IWh093 P0004 0.00 0.00 0.00 0.00 A RECORDING REQUESTED BY CITY OF ROSEMEAD AND WHEN RECORDED MAIL TO: Name City of Rosemead Street Address 8838 E. Valley Blvd. City & state Rosemead, CA 91770 ATTN: CITY CLERK Notice is hereby given that: 23470713 IIIIIIIVIIIVIIIVIIIVIIIVIIIVIIIVIIIIIIIIIII Batch Number: 14088777 IIIIII VIII VIII VIII VIII VIII Ilill VIII IIII IIII SPACE ABOVE THIS LINE FOR RECORDER'S USE Notice of Completion 1. The undersigned is owner of the interest or estate stated below in the property hereinafter described. 2. The full name of the undersigned is: City of Rosemead 3. The full address of the undersigned is: 8838 E. Valley Blvd., Rosemead, CA 91770 4. The nature of the title of the undersigned is: In fee (If other than fee, strike "In fee" and insert, for example, "purchaser under contract of purchase", or"lessee") 5. The full names and full addresses of all persons, if any, who hold title with the undersigned are: Names Addresses N/A N/A 6. The names of the predecessors in interest of the undersigned, if the property was transferred subsequent to the commencement of the work of improvement herein referred to: Names Addresses N/A N/A no transfer made, insert, "none".) 7. A work of improvement on the property hereinafter described was completed on: May 9, 2023 8. The name of the contractor, if any for such work of improvement was: R Dependable Construction, Inc. 9. The property on which said work of improvement was completed is in the City of Rosemead County of Los Angeles , State of California, and is described as follows: Rosemead Park Restroom Renovation Project No. 39003 10. The street address of said property is: 4343 Encinita Ave, Rosemead, CA 91770 no street address nas Dean orricially assigned, insert none Signature of owner named Dated: ftj It�j ! PIS in paragraph 2: Ben Kim i City Manager By: City of Rosemead I certify (or declare) under penalty of perjury that the foregoing is true and correct. b�l6�Za23 Date Ben Kim City Manager City of Rosemead, California Rosemead, CA Place of Execution CALIFORNIA ACKNOWLEDGMENT CIVIL CODE § 1189 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of Californ' 1 County of Onbefore me, tV�t"`1WAWd� nN"^hl Q�, Date Here Insert Name and Title bf the Offlt&r personally appeared Signe who proved to me on the basis of satisfactory evidence to be the person( whose namefvfisA rrsubscribed to the within instrument and acknowledged to me that h0sfMalmyexecled the same in hisAerAkeir authorized capacity,(Wg), and that by his)'! erAl el r signatureVon the instrument the person or the entity upon behalf of which the personXacted, executed the instrument. RNATALIE HAWOirrH Notary Public •California Los Angeles County Commission R 2027955 o' My Comm. Expires Dec 20, 2026 Place Notary Seal and/or Stamp Above I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. Signature AW "IAMWNak Signaturejf Notary Public Completing this information can deter alteration of the document or fraudulent reattachment of this for to �1an unintt er�ncted document ��,pp�� Description of Attached Document\(�+ Wmt1�►`�� ��d"'r*'O" Title or Type of Document: P-JQl, ern�I h�i Document Date: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: ❑ Corporate Officer — Title(s): O Partner — ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Other: Signer is Representing: ❑ Guardian or Conservator ©2019 National Notary Association ber of Pages: Signer's Name: ❑ Corporate Officer — Title(s): ❑ Partner— ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer is Representing: �F �ti\RpOR�9 CONSTRUCTION CONTRACT C21p 2, ROSEMEAD PARK RESTROOM RENOVATION PROJECT (R DEPENDABLE CONSTRUCTION, INC.) 1. PARTIES AND DATE This Contract is made and entered into this 13t" day of December, 2022 (Effective Date) by and between the City of Rosemead, a municipal corporation of the State of California, located at 8838 E. Valley Blvd., Rosemead, California 91770, ("City") and R Dependable Construction, Inc. with its principal place of business at 1019 W. V Street, Suite B, San Bernardino, CA 92410 (hereinafter referred to as "Contractor"). City and Contractor are sometimes individually referred to as "Party" and collectively as "Parties" in this Contract. 2. RECITALS 2.1 Contractor Contractor desires to perform and assume responsibility for the Rosemead Park Restroom Renovation Project on the terms and conditions set forth in this Contract. Contractor represents that it is experienced in providing such work services to public clients, that it and its employees or subcontractors have all necessary licenses and permits to perform the Services in the State of California, and that is familiar with the plans of City. 2.2 Project City desires to engage Contractor to render such services described herein as Project ("Project") as set forth in this Contract. 3. TERMS 3.1 Scope of Services and Term 3.1.1 General Scope of Services. Contractor promises and agrees to furnish to the City all labor, materials, tools, equipment, services, and incidental and customary work necessary to fully and adequately supply the professional construction services necessary for the Project ("Services"). The Services are more particularly described in Exhibit "A" attached hereto and incorporated herein by reference. All Services shall be subject to, and performed in accordance with, this Contract, the exhibits attached hereto and incorporated herein by reference, and all applicable local, state and federal laws, rules and regulations. R Dependable Construction, Inc. Page 2 of 11 3.1.2 Term. The term of this Contract shall be from Effective Date shown above to December 13, 2023 unless earlier terminated as provided herein. Contractor shall complete the Services within the term of this Contract, and shall meet any other established schedules and deadlines. The Parties may, by mutual, written consent, extend the term of this Contract if necessary to complete the Services. 3.2 Responsibilities of Contractor. 3.2.1 Control and Payment of Subordinates; Independent Contractor. The Services shall be performed by Contractor or under its supervision. Contractor will determine the means, methods and details of performing the Services subject to the requirements of this Contract. City retains Contractor on an independent contractor basis and not as an employee. Contractor retains the right to perform similar or different services for others during the term of this Contract. Any additional personnel performing the Services under this Contract on behalf of Contractor shall also not be employees of City and shall at all times be under Contractor's exclusive direction and control. Contractor shall pay all wages, salaries, and other amounts due such personnel in connection with their performance of Services under this Contract and as required by law. Contractor shall be responsible for all reports and obligations respecting such additional personnel, including, but not limited to: social security taxes, income tax withholding, unemployment insurance, disability insurance, and workers' compensation insurance. 3.2.2 Schedule of Services: Contractor shall perform the Services expeditiously, within the term of this Contract, and within the schedules timeline. Contractor represents that it has the professional and technical personnel required to perform the Services in conformance with such conditions. In order to facilitate Contractor's conformance with the Schedule, City shall respond to Contractor's submittals in a timely manner. Upon request of City, Contractor shall provide a more detailed schedule of anticipated performance to meet the Schedule of Services. 3.2.3 Conformance to Applicable Requirements. All work prepared by Contractor shall be subject to the approval of City. 3.2.4 City's Representative. The City hereby designates the City Manager, Ben Kim, or his designee, to act as its representative for the performance of this Contract ("City's Representative"). City's Representative shall have the power to act on behalf of the City for all purposes under this Contract. Contractor shall not accept direction or orders from any person other than the City's Representative or his or her designee. 3.2.5 Contractor's Representative. Contractor hereby designates Rosemary Padilla, or his designee, to act as its representative for the performance of this Contract ("Contractor's Representative"). Contractor's Representative shall have full authority to represent and act on behalf of the Contractor for all purposes under this Contract. The Contractor's Representative shall supervise and direct the Services, using his/her best skill and attention, and shall be responsible for all means, methods, techniques, sequences and procedures and for the satisfactory coordination of all portions of the Services under this Contract. R Dependable Construction, Inc. Page 3 of 11 3.2.6 Coordination of Services. Contractor agrees to work closely with City staff in the performance of Services and shall be available to City's staff, consultants and other staff at all reasonable times. 3.2.7 Standard of Care; Performance of Employees. Contractor shall perform all Services under this Contract in a skillful and competent manner, consistent with the standards generally recognized as being employed by professionals in the same discipline in the State of California. Contractor represents and maintains that it is skilled in the professional calling necessary to perform the Services. Contractor warrants that all employees and subcontractors shall have sufficient skill and experience to perform the Services assigned to them. Finally, Contractor represents that it, its employees and subcontractors have all licenses, permits, qualifications and approvals of whatever nature that are legally required to perform the Services, including a City Business License if applicable, and that such licenses and approvals shall be maintained throughout the term of this Contract. As provided for in the indemnification provisions of this Contract, Contractor shall perform, at its own cost and expense and without reimbursement from the City, any services necessary to correct errors or omissions which are caused by the Contractor's failure to comply with the standard of care provided for herein. Any employee of the Contractor or its sub -contractors who is determined by the City to be uncooperative, incompetent, a threat to the adequate or timely completion of the Project, a threat to the safety of persons or property, or any employee who fails or refuses to perform the Services in a manner acceptable to the City, shall be promptly removed from the Project by the Contractor and shall not be re-employed to perform any of the Services or to work on the Project. 3.2.8 Laws and Regulations. Contractor shall keep itself fully informed of and in compliance with all local, state aind federal laws, rules and regulations in any manner affecting the performance of the Project or the Services, including all Cal/OSHA, AQMD requirements, and shall give all notices required by law. Contractor shall be liable for all violations of such laws and regulations in connection with Services. If the Contractor performs any work knowing it to be contrary to such laws, rules and regulations and without giving written notice to the City, Contractor shall be solely responsible for all costs arising therefrom. Contractor shall defend, indemnify and hold City, its officials, directors, officers, employees and agents free and harmless, pursuant to the indemnification provisions of this Contract, from any claim or liability arising out of any failure or alleged failure to comply with such laws, rules or regulations. 3.2.9 Insurance: Contractor shall maintain, prior to the beginning of and for the duration of this Contract, insurance coverage as specified in Exhibit B attached to and part of this Contract. 3.2.10 Safety. Contractor shall execute and maintain its work so as to avoid injury or damage to any person or property. In carrying out its Services, the Contractor shall at all times be in compliance with all applicable local, state and federal laws, rules and regulations, and shall exercise all necessary precautions for the safety of employees appropriate to the nature of the work and the conditions under which the work is to be performed. Safety precautions as applicable shall include, but shall not be limited to: (A) R Dependable Construction, Inc. Page 4 of 11 adequate life protection and life saving equipment and procedures; (B) instructions in accident prevention for all employees and subcontractors, such as safe walkways, scaffolds, fall protection ladders, bridges, gang planks, confined space procedures, trenching and shoring, equipment and other safety devices, equipment and wearing apparel as are necessary or lawfully required to prevent accidents or injuries; and (C) adequate facilities for the proper inspection and maintenance of all safety measures. 3.2.11 Prevailing Wages. Contractor is aware of the requirements of California Labor Code Section 1720, et seq., and 1770, et seq., as well as California Code of Regulations, Title 8, Section 1600, et seq., ("Prevailing Wage Laws"), which require the payment of prevailing wage rates and the performance of other requirements on "public works" and "maintenance" projects. If the Services are being performed as part of an applicable "public works" or "maintenance" project, as defined by the Prevailing Wage Laws, and if the total compensation is $1,000 or more, Contractor agrees to fully comply with such Prevailing Wage Laws. City shall provide Contractor with a copy of the prevailing rates of per diem wages in effect at the commencement of this Contract. Contractor shall make copies of the prevailing rates of per diem wages for each craft, classification or type of worker needed to execute the Services available to interested parties upon request, and shall post copies at the Contractor's principal place of business and at the project site. Contractor shall defend, indemnify and hold the City, its elected officials, officers, employees and agents free and harmless from any claim or liability arising out of any failure or alleged failure to comply with the Prevailing Wage Laws. 3.2.12 Bonds. 3.2.12.1 Performance Bond: If specifically requested by City, Contractor shall execute and provide to City concurrently with this Contract a Performance Bond in the amount of the total, not -to -exceed compensation indicated in this Contract, and in a form provided or approved by the City. If such bond is required, no payment will be made to Contractor until it has been received and approved by the City. 3.2.12.2 Payment Bond. If required bylaw or otherwise specifically requested by City, Contractor shall execute and provide to City concurrently with this Contract a Payment Bond in the amount of the total, not -to -exceed compensation indicated in this Contract, and in a form provided or approved by the City. If such bond is required, no payment will be made to Contractor until it has been received and approved by the City. 3.2.12.3 Bond Provisions. Should, in City's sole opinion, any bond become insufficient or any surety be found to be unsatisfactory, Contractor shall renew or replace the affected bond within 10 days of receiving notice from City. In the event the surety or Contractor intends to reduce or cancel any required bond, at least thirty (30) days prior written notice shall be given to the City, and Contractor shall post acceptable replacement bonds at least ten (10) days prior to expiration of the original bonds. No further payments shall be deemed due or will be made under this Contract until any replacement bonds required by this Section are accepted by the City. To the extent, if any, that the total compensation is increased in accordance with the Contract, the Contractor shall, upon request of the City, cause the amount of the bonds to be increased accordingly and shall promptly deliver satisfactory evidence of such increase to the City. To the extent available, R Dependable Construction, Inc. Page 5 of 11 the bonds shall further provide that no change or alteration of the Contract (including, without limitation, an increase in the total compensation, as referred to above), extensions of time, or modifications of the time, terms, or conditions of payment to the Contractor, will release the surety. If the Contractor fails to furnish any required bond, the City may terminate this Contract for cause. 3.2.12.4 Surety Qualifications. Only bonds executed by an admitted surety insurer, as defined in Code of Civil Procedure Section 995.120, shall be accepted. The surety must be a California -admitted surety with a current A.M. Best's rating no less than A:VIII and satisfactory to the City. If a California -admitted surety insurer issuing bonds does not meet these requirements, the insurer will be considered qualified if it is in conformance with Section 995.660 of the California Code of Civil Procedure, and proof of such is provided to the City. 3.3 Fees and Payments. 3.3.1 Compensation. The total compensation shall not exceed Two Hundred Ninety Thousand Dollars ($290,000) without advance written approval of City's project manager. Extra Work may be authorized, as described below, and if authorized, will be compensated at the rates and manner set forth in this Contract. 3.3.2 Payment of Compensation. Contractor shall submit to City a monthly itemized statement that indicates work completed and hours of Services rendered by Contractor. The statement shall describe the amount of Services and supplies provided since the initial commencement date, or since the start of the subsequent billing periods, as appropriate, through the date of the statement. City shall, within 45 days after receiving such statement, review the statement and pay all approved charges. The payments will be subject to a 5% retention amount, which would be released and paid after all work under the Contract has been satisfactorily completed, and 35 days after a Notice of Completion is filed with the County of Los Angeles. 3.3.3 Reimbursement for Expenses. Contractor shall not be reimbursed for any expenses unless authorized in writing by City. 3.3.4 Extra Work. At any time during the term of this Contract, City may request that Contractor perform Extra Work. As used herein, "Extra Work" means any work that is determined by City to be necessary for the proper completion of the Project, but which the parties did not reasonably anticipate would be necessary at the execution of this Contract. Contractor shall not perform, nor be compensated for, Extra Work without written authorization from City's Representative. 3.4 Accounting Records. 3.4.1 Maintenance and Inspection. Contractor shall maintain complete and accurate records with respect to all costs and expenses incurred under this Contract. All such records shall be clearly identifiable. Contractor shall allow a representative of City during normal business hours to examine, audit, and make transcripts or copies of such records and any other documents created pursuant to this Contract. Contractor shall allow R Dependable Construction, Inc. Page 6 of 11 inspection of all work, data, documents, proceedings, and activities related to the Contract for a period of three (3) years from the date of final payment under this Contract. 3.5 General Provisions. 3.5.1 Termination of Contract. 3.5.1.1 Grounds for Termination. City may, by written notice to Contractor, terminate the whole or any part of this Contract at any time and without cause by giving written notice to Contractor of such termination, and specifying the effective date thereof, at least seven (7) days before the effective date of such termination. Upon termination, Contractor shall be compensated only for those services that have been adequately rendered to City, and Contractor shall be entitled to no further compensation. Contractor may not terminate this Contract except for cause. 3.5.1.2 Effect of Termination. If this Contract is terminated as provided herein, City may require Contractor to provide all finished or unfinished Documents and Data and other information of any kind prepared by Contractor in connection with the performance of Services under this Contract. Contractor shall be required to provide such document and other information within fifteen (15) days of the request. 3.5.1.3 Additional Services. In the event this Contract is terminated in whole or in part as provided herein, City may procure, upon such terms and in such manner as it may determine appropriate, services similar to those terminated. 3.5.2 Delivery of Notices. All notices permitted or required underthis Contract shall be given to the respective parties at the following address, or at such other address as the respective parties may provide in writing for this purpose: CONTRACTOR: CITY: R Dependable Construction, Inc. 1019 W. 3'd Street, Suite B San Bernardino, CA 92410 Attn: Rosemary Padilla Tel: (909) 381-2310 City of Rosemead 8838 E. Valley Boulevard Rosemead, CA 91770 Attn: Ben Kim, City Manager Such notice shall be deemed made when personally delivered or when mailed, forty-eight (48) hours after deposit in the U.S. Mail, first class postage prepaid and addressed to the party at its applicable address. Actual notice shall be deemed adequate notice on the date actual notice occurred, regardless of the method of service. R Dependable Construction, Inc. Page 7 of 11 3.5.3 Cooperation; Further Acts. The Parties shall fully cooperate with one another, and shall take any additional acts or sign any additional documents as may be necessary, appropriate or convenient to attain the purposes of this Contract. 3.5.4 Attorney's Fees. If either party commences an action against the other party, either legal, administrative or otherwise, arising out of or in connection with this Contract, the prevailing party in such litigation shall be entitled to have and recover from the losing party reasonable attorney's fees and all other costs of such action. 3.5.5 Indemnification. Contractor shall defend, indemnify and hold the City, its officials, officers, employees, volunteers and agents free and harmless from any and all claims, demands, causes of action, costs, expenses, liability, loss, damage or injury, in law or equity, to property or persons, including wrongful death, in any manner arising out of or incident to any alleged acts, omissions or willful misconduct of Contractor, its officials, officers, employees, agents, consultants and contractors arising out of or in connection with the performance of the Services, the Projector this Contract, including without limitation the payment of all consequential damages and attorneys fees and other related costs and expenses. Contractor shall defend, at Contractor's own cost, expense and risk, any and all such aforesaid suits, actions or other legal proceedings of every kind that may be brought or instituted against City, its directors, officials, officers, employees, agents or volunteers. Contractor shall pay and satisfy any judgment, award or decree that may be rendered against City or its directors, officials, officers, employees, agents or volunteers, in any such suit, action or other legal proceeding. Contractor shall reimburse City and its directors, officials, officers, employees, agents and/or volunteers, for any and all legal expenses and costs incurred by each of them in connection therewith or in enforcing the indemnity herein provided. Contractor's obligation to indemnify shall not be restricted to insurance proceeds, if any, received by the City, its directors, officials, officers, employees, agents or volunteers. 3.5.6 Entire Contract. This Contract contains the entire Contract of the parties with respect to the subject matter hereof, and supersedes all prior negotiations and understandings. This Contract may only be modified by a writing signed by both parties. 3.5.7 Governing Law. This Contract shall be governed by the laws of the State of California. Venue shall be in Los Angeles County. 3.5.8 Time of Essence. Time is of the essence for each and every provision of this Contract. 3.5.9 City's Right to Employ Other Contractors. City reserves right to employ other contractors in connection with this Project. 3.5.10 Successors and Assigns. This Contract shall be binding on the successors and assigns of the parties. 3.5.11 Assignment or Transfer. Contractor shall not assign, hypothecate, or transfer, either directly or by operation of law, this Contract or any interest herein without the prior written consent of the City. Any attempt to do so shall be null and void, and any assignees, hypothecates or transferees shall acquire no right or interest by reason of such R Dependable Construction, Inc. Page 8 of 11 attempted assignment, hypothecation or transfer. 3.5.12 Construction; References; Captions. Since the Parties or their agents have participated fully in the preparation of this Contract, the language of this Contract shall be construed simply, according to its fair meaning, and not strictly for or against any Party. Any term referencing time, days or period for performance shall be deemed calendar days and not workdays. All references to Contractor include all personnel, employees, agents, and subcontractors of Contractor, except as otherwise specified in this Contract. All references to City include its elected officials, officers, employees, agents, and volunteers except as otherwise specified in this Contract. The captions of the various articles and paragraphs are for convenience and ease of reference only, and do not define, limit, augment, or describe the scope, content, or intent of this Contract. 3.5.13 Amendment; Modification. No supplement, modification, or amendment of this Contract shall be binding unless executed in writing and signed by both Parties. 3.5.14 Waiver. No waiver of any default shall constitute a waiver of any other default or breach, whether of the same or other covenant or condition. No waiver, benefit, privilege, or service voluntarily given or performed by a Party shall give the other Party any contractual rights by custom, estoppels, or otherwise. 3.5.15 No Third Party Beneficiaries. There are no intended third party beneficiaries of any right or obligation assumed by the Parties. 3.5.16 Invalidity; Severability. If any portion of this Contract is declared invalid, illegal, or otherwise unenforceable by a court of competent jurisdiction, the remaining provisions shall continue in full force and effect. 3.5.17 Prohibited Interests. Contractor maintains and warrants that it has not employed nor retained any company or person, other than a bona fide employee working solely for Contractor, to solicit or secure this Contract. Further, Contractor warrants that it has not paid nor has it agreed to pay any company or person, other than a bona fide employee working solely for Contractor, any fee, commission, percentage, brokerage fee, gift or other consideration contingent upon or resulting from the award or making of this Contract. For breach or violation of this warranty, City shall have the right to rescind this Contract without liability. For the term of this Contract, no member, officer or employee of City, during the term of his or her service with City, shall have any direct interest in this Contract, or obtain any present or anticipated material benefit arising therefrom. 3.5.18 Equal Opportunity Employment. Contractor represents that it is an equal opportunity employer and it shall not discriminate against any subcontractor, employee or applicant for employment because of race, religion, color, national origin, handicap, ancestry, sex or age. Such non-discrimination shall include, but not be limited to, all activities related to initial employment, upgrading, demotion, transfer, recruitment or recruitment advertising, layoff or termination. Contractor shall also comply with all relevant provisions of City's Minority Business Enterprise program, Affirmative Action Plan or other related programs or guidelines currently in effect or hereinafter enacted. R Dependable Construction, Inc. Page 9 of 11 3.5.19 Labor Certification. By its signature hereunder, Contractor certifies that it is aware of the provisions of Section 3700 of the California Labor Code that require every employer to be insured against liability for Worker's Compensation or to undertake self- insurance in accordance with the provisions of that Code, and agrees to comply with such provisions before commencing the performance of the Services. 3.5.20Authority to Enter Contract. Contractor has all requisite power and authority to conduct its business and to execute, deliver, and perform the Contract. Each Party warrants that the individuals who have signed this Contract have the legal power, right, and authority to make this Contract and bind each respective Party. 3.5.21 Counterparts. This Contract may be signed in counterparts, each of which shall constitute an original. 3.6 Subcontracting. 3.6.1 Prior Approval Required. Contractor shall not subcontract any portion of the work required by this Contract, except as expressly stated herein, without prior written approval of City. Subcontracts, if any, shall contain a provision making them subject to all provisions stipulated in this Contract. [SIGNATURES ON NEXT PAGE] R Dependable Construction, Inc. Page 10 of 11 CITY OF ROSEMEAD R DEPENDABLE CONSTRUCTION, INC. By , Ben Kim, ity Manager Date Signat r Date Nam e:P,�� PajolG Print Attest: Title:�r i cry !Z Ericka FTernandez, City Clerk ate [If Corporation, TWO SIGNATURES, President OR Vice President AND Secretary, AND CORPORATE SEAL OF CONTRACTOR REQUIRED] Approved as to Form: / 2 /3 ZZ Rachel ichman, City Attorney ate R Dependable Construction, Inc. EXHIBIT A SCOPE OF CONTRACT SERVICES SEE ATTACHED BID SCHEDULE/PROPOSAL BIDDER: R DEPENDABLE CONST INC (CITY 0111 ROS EMEAD ROSEMEAD PARK RESTROOM RENOVATION PROJECT PROJECT No. 39003 SECTION I - BID SCHEDULC CONTRACT BID FORMS CBF-1 BIDDER: R DEPENDABLE CONST INC REVISED BASE BID SCHEDULE PER ADDENDUM 1 SCHEDULE OF PRICES FOR ROSEMEAD PARK RESTROOM RENOVATION PROJECT PROJECT No. 39003 NO, ITEM DESCRIPTION EST. QTY. UNIT UNIT PRICE ITEM COST 1 Installation of accessibility sign at entrance to parking lot. 1 LS $ 1,500.00 $ 1,500.00 2 Diversion of Recyclable Waste Materials 1 LS $ 4,930.00 $ 4.930.00 3 Site Work: Demolition- Removal and disposal of concrete slab, Interior fixtures, walls, plumbing, pavement, tile, incidentals per plans ands specifications 1 LS $ 26,050.00 $ 26,050.00 4 Concrete Foundation/ Slab: Construct new slab and level floors as necessary 1 LS $ 20.300.00 $ 20,300.00 5 Metals: Provide and install all miscellaneous metal and metal fabrications in place to CMU wall to attach restroom fixtures to CMU wall, as indicated on the Contract Drawings 1 LS $ 2,280.00 $ 2,280.00 6 Plastics: Rough Carpentry 1 LS $4,495.00 $ 4,495.00 7 Plastics: Interior Finish Carpentry 1 LS $ 6,090.00 $ 6,090.00 8 Plastics: Other Plastics 1 LS $ 5.220.00 $ 5,220.00 9 Doors: Metal Doors 2 LS $ 9,810.00 $ 9,810.00 10 Doors: Finish Hardware 1 LS $18,850.00 $18,850.00 11 Finishes: Metal Framing And Furring 1 LS $ 13,890.00 $ 13,890,00 12 Finishes: Gypsum Board 1 LS $13,630.00 $ 13,630,00 13 Finishes: Ceramic Tile 1 LS $ 47,8%,00 $ 47,850.00 14 Finishes: Anti -Graffiti Coating 1 LS $ 1,500.00 $ 1,500.00 15 Finishes: Painting 1 LS $ 6,815.00 $ 6,815.00 CBF-2 BIDDER: R DEPENDABLE CONST INC NO, ITEM DESCRIPTION EST. QTY. UNIT UNIT PRICE ITEM COST 16 Finishes: Other Finishes, Polished Sealed /concrete at restroom entrance per finished schedule 1 LS $ 6,380.00 $ 6,380.00 17 Specialties: Toilet Partitions 1 LS $ 8,700.00 $ 8,700.00 18 Specialties: Signage 1 LS $ 4,495.00 $ 4,495.00 19 Specialties: Toilet And Bath Accessories 1 LS $ 11,600.00 $ 11,600.00 20 Specialties: Other Specialties, (Hand Drier, Baby Changing stations, etc and nor s eciticalions 1 LS $1,740.00 $ t,740.00 21 Mechanical: mechanical fan 1 LS $ 14.500.GO $ 14,500.00 22 Plumbing: Waste lines, Water lines, Vent lines, and Floor Drains, etc and per plans andspecifications 1 LS $ 6,670.00 $ 6,670.00 23 Electrical: Instant Hot Water Heaters 1 LS $ 20,300.00 $ 20,300.00 24 Electrical: Rough Electrical 1 LS $ 15.700.00 $ 15,700.00 25 Electrical: Finish Electrical 1 LS $ 8,700.00 $ 8,700.00 26 Electrical: Lighting Fixtures 1 LS $8,0_05.00 $ 8,005.00 TOTAL BASE BID AMOUNT IN NUMBERS $ 90,000.00 TOTAL BASE BID AMOUNT IN WORDS: _ TWO HUNDRED NINETY THOUSAND DOLLARS The scope of work of this Lump Sum Bid Schedule includes all work identified in the Construction Plans titled: ROSEMEAD PARK RESTROOM RENOVATION The scope of work of this Lump Sum Bid Schedule also includes all work required by the Technical Provisions included in this Bid Package for the Rosemead Park Restroom Renovation Project, Project No. 39003 CBF-3 BIDDER: R DEPENDABLE CONST INC Note: All work identified on the Construction Drawings, and required by the Special Provisions, shall be f rnished, complete in place; including all associated trades, furnishing all fixtures and furnishings, and completing all associated work necessary to deliver the improvements in complete working order. In submitting this Lump Sum Bid, the Bidder acknowledges that there will be no separate or additional payment made for completing the work required hereunder this Bid Schedule. The City reserves the right to add, delete, increase or decrease the amount of any quantity shown above, within the limits define in Section 3-2.2.1 of the Standard Specifications, to stay within the budgeted amount of this project. The undersigned agrees that these Contract Bid Forms constitute a firm offer to the Owner which cannot be withdrawn for the number of Working Days indicated in the Notice Inviting Bids from and after the bid opening date, or until a Contract for the Work is fully executed by the Owner and a third party, whichever is earlier. The undersigned also agrees that if there is a discrepancy between the written amount of the Bid Price and the numerical amount of the Bid Price, the written amount shall govem. Attached hereto is a certified check, a cashier's check or it bid bond in the amount of Bid Bond Dollars ($ ) said amount being not less than ten percent (10%) of the Total Bid Price. The undersigned agrees that said amount shall be retained by the Owner if, upon award, we fail or refuse to execute the Contract and furnish the required bonds, certificates and endorsements of insurance and other certifications within the time provided. If awarded a Contract, the undersigned agrees to execute the formal Contract, which will be prepared by the Owner for execution, within five (5) Calendar Days following the Letter of Award for the Contract, and will deliver to the Owner within that same period the necessary original Certificates of insurance, Endorsements of Insurance, Performance Bond, Payment Bond and all other documentation and certification required by the Contract. The undersigned offers and agrees that if this bid is accepted, it will assign to the purchasing body all rights, title, and interest in and to all causes of action it may have under Section 4 of the Clayton Act (15 U.S.C. Section 15) or under the Cartwright Act (Chapter 2 of Part 2 of Division 7 of the Business and Professional Code), arising from purchases of goods, materials or services by the Bidder for sale to the purchasing body pursuant to the bid. Such assignment shall be made and become effective at the time the purchasing body tenders final payment to the Contractor. Bidder understands and agrees that, when requested by Owner, he shall provide: (1) evidence satisfactory to the Owner of Bidder's California contractor's license(s) in good standing; (2) evidence that the person signing this Bid is authorized to bind Bidder to this Bid and to a contract resulting therefrom; and (3) any other information and documentation, financial or otherwise, needed by Owner to award a Contract to the lowest responsible and responsive bidder. CBF-4 BIDDER: R DEPENDABLE CONST INC Days from the date of the Notice of Proceed and subject to the terms and conditions described in the Contract Form and the Contract Documents. Bidder acknowledges that data submitted with its Contract Bid Forms which it requires to be incorporated into a Contract arising out of this Submittal has been so identified by Bidder. Bidder finther acknowledges that the Owner may, at its discretion, incorporate any of the remaining data submitted herewith into a contract arising out of this Bid. The undersigned acknowledges receipt, understanding and fidl consideration of the following addenda to the Contract Documents. Addenda Nos. The Bidder understands and agrees that the Total Bid Price is inclusive of all labor, materials, and equipment or supplies necessary to complete the Work as described in the Bid Documents. If this bid is accepted, the undersigned Bidder agrees to enter into and execute the Contract with the necessary bonds and accept the Total Bid Price as compensation in full for all Work under the contract. 543.1 BIDDER: R DEPENDABLE CONST tNC PUBLIC CONTRACT CODE STATEMENT AND QUESTIONAIRE PUBLIC CONTRACT CODE SECTION 10285.1 STATEMENT In conformance with Public Contract Code Section 10285.1 (Chapter 376, Stats.1985), the bidder hereby declares under penalty of perjury under the laws of the Stale of California that the bidder has _ , has not _ been convicted within the preceding three years of any offenses referred to in that section, including any charge of fraud, bribery, collusion, conspiracy, or any other act in violation of any state or Federal antitrust law in connection with the bidding upon, award of, or performance of, any public works contract, as defined in Public Contract Code Section 1101, with any public entity, as defined in Public Contract Code Section 1100, including the Regents of the University of California or the Trustees of the California State University. The term "bidder" is understood to include any partner, member, officer, director, responsible managing officer, or responsible managing employee thereof, as referred to in Section 10285.1, Note: The bidder must place a checkmark after "has" or "has not" in one of the blank spaces provided. The above Statement is pad of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Statement. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. PUBLIC CONTRACT CODE SECTION 10162 QUESTIONNAIRE In conformance with Public Contract Code Section 10162, the Bidder shall complete, under penalty of perjury, the following questionnaire: Has the bidder, any officer of the bidder, or any employee of the bidder who has a proprietary interest in the bidder, ever been disqualified, removed, or otherwise prevented from bidding on, or completing a federal, state, or local government project because of a violation of law or a safety regulation? Yes _ No If the answer is yes, explain the circumstances in the following space. CBF-6 BIDDER: R DEPENDABLE CONST INC PUBLIC CONTRACT CODE 10232 STATEMENT In conformance with Public Contract Code Section 10232, the Contractor, hereby states under penally of perjury, that no more than one final unappealable finding of contempt of court by a federal court has been issued against the Contractor within the Immediately preceding two-year period because of the Contractor's failure to comply with an order of a federal court which orders the Contractor to comply with an order of the National Labor Relations Board Note: The above Statement and Questionnaire are part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Statement and Questionnaire. Bidders are cautioned [hat making a false certification may subject the certifier to criminal prosecution. CBF-7 r By:"> Signature ROSEMARY PADILLA Type or Print Name PRESIDENT Title BIDDER: R DEPENDABLE CONST INC 1019 W. 3RD STREET, SUITE B Business Street Address SAN BERNARDINO, CA 92410 City, State and Zip Code 909-381-23I0 Telephone Number Bidder's/Contractor's State of Incorporation: CALIFORNINA Partners or Joint Venturers: Bidder's License Number(s):, Department Industrial Relations Registered No. NOTES: 944088 1000002054 N/A 1) By its signature on this Bid, the Bidder certifies under penalty of perjury the accuracy of the representations made on the Contract Bid Forms.. 2) If Bidder is a corporation, enter State of Incorporation in addition to Business Address 3) If Bidder is a partnership or joint venture, give full names of all partners or joint venturers. As further discussed in the Instructions to Bidders, Bidder will be required to provide evidence that the person signing on behalf of the corporation, partnership or joint venture has the authority to do so. •e o BIDDER: R DEPENDABLE CONST INC SECTION 2 BID DATA FORMS NAME BIDDER: R Dependable Const Inc Bidder shall submit its Bid data in accordance with die format shown on each of the following Bid Data Forms. Bidders shall prepare and use as many sheets as are necessary to adequately provide the information required. Bidder shall ensure that every page of its Bid Data Forms are properly identified with the Bidder's name and page number. 2.A BID BOND KNOW ALL MEN BY THESE PRESENTS: THAT R Dependable Const Inc as Prill as Surety, are held firmly bound unto the CITY Of ROSEMEAD (hereinafter called the OWNER) in the sum of Ten Percent Amount of Bid DOLLARS ($ 10% ), being not less than ten percent (10%) of the Total Bid Price; for the payment of which sum will and truly to be made, we bind ourselves, our heirs, executors, administrates, successors, and assigns, jointly and severally, firmly by these presents. WHEREAS, said Principal has submitted a bid to the OWNER to perform all Work required for the ROSEMEAD PARK RESTROOM RENOVATION PROJECT —as set forth in the Notice Inviting Bids and accompanying Bid Documents, dated October 13, 2022 NOW, THEREFORE, if said Principal is awarded a Conti -act for the Work by the OWNER and, within the time and in the manner required by the above- referenced Bid Documents, enters into the written form of Contract bound with said Bid Documents, furnishes the required bonds (one to guarantee faithful performance and the other to guarantee payment for labor and materials) furnishes the required insurance certificates and endorsements, and furnishes any other certifications as may be required by the Contract, then this obligation shall be null and void; otherwise it shall remain in full force and effect. In the event suit is brought upon this bond by the OWNER and judgment is recovered, said Surety shall pay all costs incurred by the OWNER in such suit, including reasonable attorneys' fees to be fixed by the court. SIGNED AND SEALED, this 10th day of October , 2022 R Dependable Const Inc (SEAL) The Ohl Casualty lnsurameCompany(SEAL) Priuci al S eq� I t A , By: By: !b Signanure Ro4em Padilla, President , igtahure As ley N. Baker, Attorney -in -Fact CBF-10 Nutua berty SURETY Thta Power of Attorney limits the ache Whose named "In, end they In" no authority to bind the Company esceptIn the manoor mdto tho atchmt heroin ateted. Liberty Mutual Insurance Company The Ohio Casualty Insurance Company WastAmerican Insurance Company POWER OF ATTORNEY Cori"a No: 8208023-087721 BY THESE PRESENTS: That The 0* OmRy Insoranoe Company a a 00"lon dry organized under the laws of the Slate or Now Hampshire, that lompaM Is a caporalM dal! orgvn¢ed NrdW the lave Oflho Slate of Messacblselb, and Wss1 American Insurance Company Is a corpaafi n duty organized hdlMana(tnasln OollorfJvety railed hire'Conparip'), pumuard to end bl aAtrority here!n sal realty, does hereby tharntt coratXule and appo'nl, AshleyV. .I. T A.M. exeade,sani,advtaMedgie an dFvw—,fo—ranTo—ndsbetatassurety,'enYandeNundeAakirOs,londs,rewgrArancesandothersumlYcbige6ons,btpureueltre d these presents and shall be as blo ft upon the Compares as If they have been dk* signed by the Presidsril and aleslod by the seremry d the COMPON09 In Ihelr Own Proper poems. IN VATNESS WHEREOF fibs Poway orAXarey has been subscribed by an augnAmd dtcnr a ottcal of the Companies and the ooryorote seeds of the Companies have been affixed thoretoth's 11th dayol May . 2022 . nq` Liberty Mutual Insurance Company JPy I� rid lNyU,$ �1NeU2, The Ohio Casualty ati A`� M'b' non �O"4Wgy �ypPOa„®� Cco Company westAmericancan Insurance Company ° E1812 m j 1919 � "� 1991 0 �MJ w 1•� alit *W'^�C r�y'2M-.uty*N.da By, r. ha M ,- �2022^ before MO POurelly oppmred Devid M. Carey, whw�N o Wkadgedhlmse7lo betlheA£sislan Ssae%q of Liberty NtUval Casum Conpaml, alai esl Arnercan Insurance Compaq, and that he, as endl bring authorized so to do, ereade the foregoNp instrument for the etgntng on bdaTdthe corpordkns by himself as a (My authorized oPicar. IN MATNESS WHEREOP, I have hereunto slbsaNted myname and affixed my notarial seat at Ktrg o(Pma* Pmnsyhmlka . on the ray andyearhnd above wrdten. yo- vner Qt' nb FC OmmxeaNq➢am'IMne-KMeTBaY tic � �s Y Teem➢aero, NNuyrlWo ,�/// WmmkrkneWmuxwa>, sus By: 'A Y e wmi'edv,nmEa•fumu wm,evan,re,.on+ms«.aaa.n,. arena Panda, NdayPubNc 4qy This Power of Aftomey Is made and eveculod pmslud to and by aulhorhy of the following BY-..180 and Authatzd'ora of The Olio Casualy msumnaa Cmlpary, Liberty mutant Insurance Company, ad WestArracan Insurance Company witch resolutions are cow In fW force and died reading as knows: ARTICLE IV—OFFICERB; Sedan 12 Power dAtomey. Any o1ber or other o8ckl d the CoWallon arghcrM for tal purpose In wrimig by the Chairman of the President end sti jed to such Nmlldon as the Chairman or tie Rod" may Proscribe. shelf eppdrA such atorneyahn•facl, an seal be necussmy to ad in behalf of the Corpaaibn IQ make, execute, seed, aftowledge and deliver as sw®r any and at undoddlaga, bonds, reoogrizances and other surely obligations. Such etorwyaMad, subject b the IimNatune, eel forth In Uhelr respective poxes d at omay, call have full Prewar to third the Coryadlm by their sgnatvm and areatlm of aq such Imbumathb and to chatty tlhado the seal of the Conpaatsn. When se exacted, such Instruments be as Unclog as If signed by the Preshac and atested to by the Secretmry. Any pansy or mAhady graded to my repreaceffiIbe or otanay*fad under to provisions of this adice may be revoked at any none by the Board the Ch amarl, the PfesldW or by the dfica or officers graning such power or authority. ARTICLE All — ExseWon of Centnift Sedcn S. Surely Bonds and Undertaking& Any drm ofthe Company authorized for tut purpose In writing by the chairman or the pros". and sAod to such ItnAa One as the chairmen or the presided may pros rb% M appoint such dormays,Wed, as may be necessary to ad In behalf of tho Cmpvey to make, execute, seal, admwiscii and dshter as sady any and all undertarro , border, roccokrU:ces and other surety ol>Egdioea. Such a9mhePWW Unbind to the limitations set forth b their respective powers Of etomoy, chat have fuD powal to bird fie Corson by (heir signature and mmohton of any such kurhumenb and to atach tarelo the seal Of Ihs Comlamy. When so executed such NsinrnoMsslhah be as btndlrp as X signed by the president andetlesled by the nxdetary. CertAcNe of Deelgmton —The Preacant ofthe Comfoarq, aft pursuant to the Bylaws ofthe Compaq, authorizes Dadd M. Carey, Assistant Seaelary to appokN such atarnyslo- fad as may be necessary to ad on behalf of the Company to make, exec*, seal, sUmAD lie and delver as surety any and al undorlaktngs, bonds, recogntwoes and other surety, obwons. Aefhadntoo —By urnanimous errant ofthe Compenys Board of Directors, me Company consents that facsimile ormechanically reproduced slgndNre ofany assistant suaefery orthe Company, wtherevar appearing upon a ce liied copy of any power of etionrey Issued by the Caapany In connection w9h surety, bonds, slap be valid and birxing upon tie Conlpary WNh the same force and effect as though manually Offered. 1, Hanes C. Llewellyn, the underotgned, Assistant Secretary, The ONO Casually Insurance Company, Liberty Muth insnranca Company, and Walt Aalecan Inamoo Company do hereby tartly that the or(dnal power of attorney Of which Eire frxagdng In a Nlt two andcorred ropy of" Power of Attorney executed by said Companies, is in NN force and cited and has not been tevdcocL ' IN TESTIMONYWHEREOF, I lave hereunto set my hand and affixed the sealsofsmd Companies this 10W clayd OotoboY , 2022 . Goo tY IN3a INIIUoM `°pav` �� °m191 8 1991 om L S,�,aeLLyv...,". g.Q 5' Y RwAYt D'r 'Mox.W' �•H1 w k�� dM + 1.� Yn B�tari $eaelaY LM61Y613 WIC OCIC WAIC Mora Co 0=1 CALIFORNIA ALL- PURPOSE CERTIFICATE OF ACKNOWLEDGMENT A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of Riverside } II 1 On `(' th C 704fore me, K. A. Eby, Notary Public ah 0%,`. - aJ1!4 Cr 1^t ortKq personally appeared Ashley N. Baker who proved to me on the basis of satisfactory evidence to be the persono whose na I pte subscribed to the within Instrument and acknowledged to me that s v,4y executed the same in WKrr eir authorized capacity( s), and that by F� e it signatures4 on the instrument the persono, or the entity upon behalf of which the perso%sfacted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my han and 'al-s al. *I ti K. A. EBV n A" 423.13693 y 1 � MUfA1rypUBIKCAl1/OgMA C `� BMIISInI [CW IIr1' V ^1tG:1': '%•avGni.w 6pinamruaelBuz:w� Notary PONZ Signature )otary Public Seat ADDITIONAL OPTIONAL INFORI )ESCRIPTION OF THE ATTACHED DOCUMENT of Pages _ Document Date CAPACITY CLAIMED BY THE SIGNER 0 Individual (s) O Corporate Officer (Title) O Partner(s) • Attorney -in -Fact • Trustee(s) p Other INSTRUCTIONS FOR COMPLETING THIS FORtNI Vur form eonnphet with ciorent California tlmulu rtgardlrg notnq uonlbsg mud. Jnxdzd, rlwuld bz eomfllnrrl Nld Ntaclk'd/O Iht d4rllnMllL A[IalaN'Iedgplj/IlI from other mart, osety be corrlyletedfor document, being nut to that stare m long or the inn ding doer not requirm die Callfmnln wormy to rlabae Col(pmla a inevy low. • State and County infamlalioh mug be the State and County where the document sienni sl personally appeased before the noarypublic for a imow'ledgment. • Dam of notarization mug be the dste that the signer(s) personally appeared which muff also be the same dam the acknowledgment Is completed. • The notary public must print his or her time as it appears within his or her commission follotced by a comma and then your GUe(notary public) • Print the namds) of document signer(s) %who personally appear at die time of notarization • Indicate the correct singular or plum] forms by crossing off incorrect forms (i.e. hs'she,theyr- is roar) or circling the correct forts. Failure to correctly indicate this information may lead to rejec(im of document recording. • The notary scat impression mug be clear and photographically reproducible. Impression must not cover tat or Imes If scat impression smudge:, reseal ifn sulfuteut area permits. ohenvise complete a dilTerent acknowledgment farm, • Signature of the notary public must match die signature an file with the office of the county clerk. Additional information is not rcrpuired but could help to ensure this acknowledgment is nor misused a attached to a different document. {• Indicate title or type ofallached document, number ofpagea and dale Indicate the capacity claimed by the signer If the claimed opacity is a corporate officer, indicate the title (i a CEO, CFir, Secravy) • Securely attach this document to the signed document w uh a staple BIDDER: It DEPENDABLE CONST INC 2,B LIST OF PROPOSED SUBCONTRACTORS in compliance with the "Subletting and Subcontracting Fair Practices Act," Sections 4100 through 4114 of the California Public Contract Code, and any amendments thereto, each Bidder shall provide the information requested below for each subcontractor who will perform work, labor or render service to Bidder in or about the construction of the Work in an amount in excess of one-half of one percent (greater than 0.5 %) of the Bidder's Total Bid Price, or, in the case of bids or offers for the construction of streets or highways, including bridges, in excess of one-half of I percent of the Contractor's total bid or ten thousand dollars ($10,000), whichever is greater, and shall further set forth the portion of the Work which will be done by each subcontractor. Bidder shall list only one subcontractor for any one portion of the Work. Pursuant to Public Contract Code Section 4104, the Owner has determined that it will allow Bidders hventy-four (24) additional hours after the deadline for submission of bids to submit the information requested by the Owner about each subcontractor, other than the name and location of each subcontractor. If the Bidder fails to specify a subcontractor for any portion of the Work to be performed under the Contract, it shall be deemed to have agreed to perform such portion itself, and shall not be permitted to subcontract that portion of the Work except under the conditions hereinafter set forth below. Subletting or subcontracting of any portion of the Work in excess of one half of one percent (greater than 0.5%) of the Total Bid Price or, in the case of bids or offers for the construction of streets or highways, including bridges, in excess of one-half of I percent of the Contractor's total bid or ten thousand dollars ($10,000), whichever is greater; for which no subcontractor was designated in the original bid shall only be permitted in cases of public emergency or necessity, and then only after Owner approval, CBF-11 BIDDER: R DEPENDABLE CONST INC 2.B LIST OF PROPOSED SUBCONTRACTORS (continued) ["Duplicate Next 2 Pages if needed for listing additional subcontractors.* *] Name and Location of Subcontractor Description of Work to be Subcontracted Name: YTI ENTERPRISES, INC. Address: 1760 S. STATE COLLEGE PKWY.. ANAHEIM, CA License No.: 830286 Department of industrial Relation Registration No, 1000005750 TOILET ACCESSORIES & PARTITONS Name and Location Description of Work of Subcontractor to be Subcontracted Name: JAM FIRE PROTECTION, INC. Address: 1930 S. MYRTLE AVE., MONROVIA, CA License No.: 791060 Department of Industrial Relation Registration No.1000005174 FIRE ALARM Name and Location of Subcontractor License No.: Department of Industrial Relation Registration No. Name and Location of Subcontractor Description of Work to be Subcontracted Description of Work to be Subcontracted License No.: Department of Industrial Relation Registration No. Name and Location Description of Work of Subcontractor to be Subcontracted Name: Address: License No.: Department of Industrial Relation Registration No. CBF-12 ---- --- -`I BIDDER: R DEPENDABLE CONST INC 2.0 REFERENCES The following are the names, addresses and telephone numbers for three public agencies for which BIDDER has performed similar work within the past two (2) years: 1. MORENO VALLEY USD, 13911 PERRIS BLVD., MORENO VALLEY, CA 92553 Name and Address of Owner JACOB ROMERO, 951-490-8968 Name and telephone number of person familiar with project RESTROOM Contract amount Type 2. CITY OF RIVERSIDE, 3900 MAIN STREET, RIVERSIDE, CA Name and Address of Owner ROBERT WISE, 909-319-3625 Name and telephone number of person familiar with project OC 0BER 2021 Dale Completed $1,392,000.00 TENANT REMODEL / SITE -WORK MAY 2022 Contract amount Type of Work Date Completed 3. CITY OF LA QUINTA, 78495 CALLE TAMPICO, LA QUINTA, CA 92553 Name and Address of Owner UBALDO AYON, 760-777-7096 Name and telephone number of with project 1.00 FIRE STATION #70 REVITALIZATION amount Type of Work CBF - 13 OCTOBER 202 t Date Completed BIDDER: R DEPENDABLE CONST INC 4. PALM SPRINGS USD, 150 DISTRICT CENTER DRIVE, PALM SPRINGS, CA 92264 Name and Address of Owner NATHANIEL RODRIGUEZ, 760-883-27I0 Name and telephone number of person familiar with project BELLA VISTA ES: CPU LAB REMODEL JANUARY amount Type of Work Date CBF-14 BIDDER: R DEPENDABLE CONST INC SECTION 3 NON -COLLUSION AFFIDAVIT CBF-15 BIDDER: R DEPENDABLE CONST INC NON -COLLUSION AFFIDAVIT In accordance with Public Contract Code Section 7106, the undersigned, being first duly sworn, deposes and says that he or she holds the position listed below with the bidder, the party making the foregoing bid, that the bid is not made in the interest of, or on behalf of, any undisclosed person, partnership, company, association, organization, or corporation; that the bid is genuine and not collusive or sham; that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly colluded, conspired, connived, or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding; that the bidder has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price of the bidder or any other bidder, or to fix any overhead, profit, or cost element of the bid price, or of that of any other bidder, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contact; that all statements contained in the bid are true; and, further, that the bidder has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, or paid, and will not pay, any fee to any corporation, partnership, company association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid. Signature R DEPENDABLE CONST INC Typed or Printed Name PRESIDENT R DEPENDABLE CONST INC Bidder Subscribed and swom before me This _ day of 20 1-Arw3e `cc Cl l ncF�n t� t Notary Public in and for the State of California My Commission Expires: CBF-16 (Seal) CALIFORNIA JURAT GOVERNMENT CODE § 8202 A notary public of other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness; accuracy, or validity of that document. State of California z Countyof `l(1) i>L'V tV,�II)i; IEATRIIA. C0R01,100RRE5 Notary f ubilr• California = Riverside County Commission a 2321354 I, y Comm. Expires Feb 13. 2024 Place Notary Seat and/or Stomp Above Subscribed and sworn to (or affirmed) before me on this. � clay of, U� �r✓IatY , 20 --��-, by Date Month Year (and (2) Nomefs) of Signers) proved to me on the basis of satisfactory evidence to be the person(s) who appeared before me, Signature Imo). C�.�cl�.,"/La-`�•�-,es Signature of Notary Public Completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: _ ��.)� � 1 �tl� y Cm) %`I i 1 C116 w Document Date: 1(�1 ��I '-" Number of Pages: Signer(s) Other Than Named Above: - &2019 National Notary Association z CIC STACONTRACTORS IARD ACTIVE LICENSE A „- .,,944088 m CORP .. ob., R DEPENDABLE CONST INC 03131/2024 vnaw.celb.ce.gov ' i`-„aha V'd t/-Vt0ee eddweakia,e a k be IPftdb the RnMb WWOn W daW Ihla ffwn I, nat VWWd ble, aM ahUl be MNdto then k*v Npbn{bAlMd when e0epen3,, ravokm, llrvaldatedMlly� , Thb paokat"M b valid through th, "*Wbn asw N. IIIwd,bop InanymN ' Paalp duamliteod br. 0w6,cbsStet,110 Rood t I PD.B =W.. 8ew mlo CA 05M ;S e e 7/5/22, 10:12 AM Reglstrallons ntractor Information Legal Entity Name R DEPENDABLE CONST INC Legal Entity Type Corporation Status Active Registration Number 1000002054 Registration effective date 07/01/22 Registration expiration date 06/30/23 Mailing Address 1019 W 3RD STREET, STE B SAN BERNAKDIN0 92410 C... Physical Address 1019 W 3RD STREET, STE B SAN BERNARDINO 92410 C... Email Address rdependable@gmall.com Trade Name/DBA License Number (s) CSLB:944088 CSLB:944088 Legal Entity Information Corporation Entity Number: Federal Employment Identification Number: President Name: Vice President Name: Treasurer Name: Secretary Name: CEO Name: 6gkL&YjX ervice: Agent of Service Name: Agent of Service Mailing Address: Worker's Compensation C3234 27102! Registration History festive Date Expiration Date /08/18 06/30/19 - - /12117 06/30/18 /10/16 06/30/17 /19/15 06/30/16 1 /21/14 06/30/15 Padilla 06/30/20 06/30/21 06/30/22 06/30/23 RosemalAl Padilla 1019 W. 3rd Street, Suite B San Bernardi Do you lease employees through Professional Employer Organization (I ED)?: Please provide your current worker's compensation insurance informat on below: PEO PLO PEO PEOlnformationName Phone Email No https:tfoadirzaeure.force.mtrdContaotorSearch/reglslrallonSearchDetalis91d=a1Rt00000048wHPEAY 1/2 1vQ 11111), - 6 WON -SEGREGATED irACULITIES CERTUFUCA,T0 Nil FEDERALLY -ASSISTED CONSTRUCTION PROJECTS The federally -assisted construction contractor certifies that he/she DOES NOT and WILL NOT: Maintain or provide, for his/her employees, any segregated facilities at any of his/her establishments. Permit his/her employees to perform their services at any location, under his/her control, where segregated facilities are maintained. The federally -assisted contractor agrees that a breach of this certification is a violation of the Equal Opportunity Clause in this contract. As used in this certification, the term segregated facilities means any waiting room, work areas, restrooms and washrooms, restaurants and other eating areas, time clocks, locker rooms and other storage or dressing areas, parking lots, drinking fountains, recreation or entertainment areas, transportation, and housing facilities provided for employees which are segregated by explicit directive or are in fact segregated on the basis of race, creed, color, or national origin, because of habit, local custom, or otherwise. The federally -assisted contractor agrees that (except where he/she has obtained identical certifications from proposed subcontractors for specific time periods) he/she will obtain identical certifications from proposed subcontractors prior to the award of subcontracts exceeding $10,000 which are not exempt from the provisions of the Equal Opportunity Clause, and that he/she will retain such certifications In his/her files. NOTE: The penalty for making false statements in offers is prescribed in 18 U.S.C. 1001. Date: 10/27/2022 Project Number: 39003 Company: R DEPENDABLE CONST INC Address: 1019 W. 3RD STREET, SUITE B, SAN BERNARDINO, CA, 92410 By: ROSEMARY PADILLA Title: PRESIDENT EXHIBIT - 7 CERTIFICATION WITH REGARD TO THE PERFORMANCE OF PREVIOUS CONTRACTS OR SUBCONTRACTS SUBJECT TO THE EQUAL OPPORTUNITY CLAUSE AND THE FILING OF REQUIRED REPORTS The E16idder, ❑proposed sub -contractor, hereby certifies that he/she ❑has, R ias not, participated in a previous contract or subcontract subject to the Equal Opportunnity Clause, as required by Executive Orders 10925, 11114, or 11246, and that he/she ❑has, 8(has not, filed with the Joint Reporting Committee, the Director of the Office of Federal Contract Compliance, a Federal Government contracting or administering agency, or the formerPresident's Committee on Equal Employment Opportunity, all reports due under the applicable filing requirements. Date: 10/27/2022 Awarding Agency: Project Number: 39003 CITY OF ROSEMEAD Contractor Name: R DEPENDABLE CONST INC Affiliate Company: NONE - N/A By: ROSEMARY PADILLA Title: PRESIDENT ContractAward: $290,000.00 Total Number of Employees 25 NOTE: The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor (41 CFR 60.1.7(b)(1), and must be submitted by bidders and proposed subcontractors only in connection with contracts and subcontracts which are subject to the equal opportunity clause. Contracts and subcontracts which are exempt from the equal opportunity clause are set forth in 41 CFR 60-1.5 (Generally only contracts or subcontracts of $10.000 or under are exempt). Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60-1.7(b)(1) prevents the award of contracts and subcontracts unless such contractor submits a report covering the delinquent period or such other period specified by the U.S. Department of the Interior or by the Director, Office of Federal Contract Compliance, U.S. Department of Labor. SF-100 (EEO-1) must be filed bv; (A) All private employers who are; (1) Subject to Title VII of the Civil Rights Act of 1964 (as amended) with 100 or more employees. (2) Subject to Title VII who has fewer than 100 employees, if the company is owned or affiliated with another company, or there is centralized ownership, control or management so that the group legally constitutes a single enterprise, and the entire enterprise employs a total of 100 or more employees. (B) All federal contractors (private employers), who: (1) Are not exempt as provided for by 41 CFR 60-1.5 (2) Have 50 or more employees, and a. Are prime contractors or first -tier subcontractors, and have a contract, subcontract, or purchase order amounting to $50,000 or more; or b. Serve as a depository of Government funds in any amount, or c. Is a financial institution, which is an issuing, and paying agent for U.S. Savings Bonds and Notes. EXHIBIT - 8 County Lobbyist Certification Name of Firm: R DEPENDABLE CONST INC Date: 10/27/2022 Address: 1019 W. 3RD STREET, SUITE B, SAN BERNARDINO, CA 92410 Telephone: ( 909 ) 381 2310 Acting on behalf of the above named firm, as its Authorized Official, I make the following certification to the County of Los Angeles, to the Community Development Commission, County of Los Angeles, and to the City of Rosemead, as the local contracting agency (LCA); 1) It is understood that each person, entity, or firm who applies for a Community Development Commission contract, and as part of that process; shall certify that they are familiar with the requirements of the Los Angeles County Code, Chapter 2.160 (Los Angeles County Ordinance 93-0031) and; 2) That all persons/entities/firms acting on behalf of the above named firm have and will comply with the County Code, and; 3) That any person, entity, or firm who seeks a contract with the Community Development Commission shall be disqualified therefrom and denied the contract and, shall be liable in civil action, if any lobbyist, lobbying firm, lobbyist employer or any other person or entity acting on behalf of the named firm fails to comply with the provisions of the County Code. This certification is material representation of facts upon which reliance was placed when this transaction was made or entered into. Authorized Official: ROSEMARY PADILLA (Print Name of Conlradoes Authodzed Representelive) PRESIDENT f (Signature of 7 athodzed Represenfatrvete 10/27/2022 (Date) EXHIBIT • 9 CAD I WPE NAil DOOM CEHRT OF9C A il'00W I certify, by signature below, that I am aware of the provisions of Section 3700 of the California Labor Code which require every employer to be insured against liability for worker's compensation or to undertake self-insurance in accordance with the provisions of that code, and I will comply with such provisions before commencing the performance of the work of this contract. Date: 10/27/2022 Project Number: 39003 Project Name: ROSEMEAD PARK RESTROOM RENOVATIONS Company Name: R DEPENDABLE CONST INC Address: 1019 W. 3RD STREET, SUITE B, SAN BERNARDINO, CA 92410 Print Name: ROSEMARY PADILLA Title: Sigm nn nn mnwrm ( m j § z ( � : § m E k / 7-e n § ]!! m £© / ) ,g § § $))$ \ ��! ! f \ : _ (G )) ( / )k$(\} \ u�}�� ! Em !2 k \ ) § \ \ \ U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT HUD FORM 4230A REPORT OF ADDITIONAL CLASSIFICATION AND RATE OI/.B Approval numE r25ai-p0iI (ap. 81312022) 1. FROM (name and address of requesting agency) 2. PROJECT NAME AND NUMBER j�y�� �jSemeaOl Rosemead Park Restrooms Renovation #39003 1 3. LOCATION OF PROJECT (City, County and State) Rosemead, LA County, Ca l� a Co / 1,270 I�fjs Off,; e� 4. BRIEF DESCRIPTION OF PROJECT 5. CHARACTER OF CONSTRUCTION Remodel of Existing Restrooms ® Building ❑ Residential ❑ Heavy ❑ Other(specify) ❑ Highway 6. WAGE DECISION NO. (include modification number, if any) DATE of WAGE DECISION: T. WAGE DECISION EFFECTIVE DATE (LOCK -IN): ❑ COPY ATTACHED 8. WORK CLASSIFICATION($) HOURLY WAGE RATES BASIC WAGE FRINGE BENEFIT(S) (If any) NONE - N/A PAYING CURRENT PREVAILING / FEDERAL WAGES AS REQUIRED 9. PRIME CONTRACTOR (name, address) 9a. 10. SUBCONTRACTORIEMPLOYER,IF APPLICABLE R DEPENDABLE CONST INC (name, address) 1019 W 3RD ST., STE B, SAN BERNARDINO, CA ®Agree ❑ Disagree 9b. SIGNATURE DATE 10/27/2022 Check All That I : ❑ The work to be performed by the additional classification(s) is not performed by a classification in the applicable wage decision. ❑ The proposed classification is utilized in the area by the construction industry. ❑ The proposed wage rate(s), including any bona fide fringe benefits, bears a reasonable relationshipto the wage rates contained in the wage decision. ❑ The interested parties, including the employees or their authorized representatives, agree on the classificalton(s) and wage rate(s). ❑ Supporting documentation attached, Including applicable wage decision. Check One: ❑ Approved, meets all criteria. DOL confirmation requested. ❑ One or more classifications fail to meet all criteria, DOL decision requested. FOR HUD USE ONLY LR2000: Agency Representative Date Log in: (Typed name and signature) Log out: Phone. Number HUD-4230A t8-19) PREVIOUS EDITION IS OBSOLETE EXHIBIT - 12 EQUAL EMPLmOYMEN APPOR u l9CIL u'ir' �>(�fUdIUdL`ii Vlflt=�l u TO: LABORERS APPRENTICESHIP (Name of Labor Union, Workers Representative, etc. 1385 W. SIERRA MADRE AVE., AZUSA, CA, 91702 (Address) Name of Business (Contractor): R DEPENDABLE CONST INC Project Name: ROSEMEAD PARK RESTROOM RENOVATIONS Project Number: 39003 The Undersigned currently holds a contract with CrrY OF ROSEMEAD , involving funds of the U. S. Government, or a subcontract with a prime contractor holding such contract. You are advised that under the provisions of the above contract or subcontract, and in accordance with Executive Order 11246, the undersigned is obligated not to discriminate against any employee or applicant for employment because of race, color, religion, sex or national origin. This obligation not to discriminate in employment Includes, but is not limited to the follow: 1. Hiring, placement, upgrading, transfer or demotion; 2. Recruitment, advertising or solicitation for employment; 3. Treatment during employment; 4. Rates of pay or other forms of compensation; 5. Selection for training, including apprenticeship; and 6. Layoff or termination. This notice is furnished to you pursuant to the provisions of the above contract. or subcontract and Executive Order 11246. Copies of this notice will be posted by the undersigned in conspicuous places available to employees or applicants for employment. ROSEMARY PADILLA (Prim Name) 10/27/2022 (Date) By: (sirna m"— ) PRESIDENT EXHIBIT - 13 NOTICE OF SECTION 3 G(0)WI l INVIENI`u' TO: LABORERS APPRENTICESHIP (Name of Labor Union, Workers Representative, ate. 1385 W. SIERRA MADRE AVE., AZUSA, CA, 91702 (Address) Name of Business (Contractor): R DEPENDABLE CONST INC Project Name: ROSEMEAD PARK RESTROOM RENOVATIONS Project Number: 39003 The Undersigned currently holds a contract with THE CITY OF ROSEMEAD involving Block Grant (CDBG) funds from the U. S. Department of Housing and Urban Development or a subcontract with a prime contractor holding such contract. You are advised that under the provisions of the above contract or subcontract and in accordance with Section 3 of the Housing and Urban Development Act of 1968, the undersigned is obligated to the greatest extent feasible, to give opportunities for employment and training to lower Income residence of the CDBG-assisted project area and to award contracts for work on the project to business concerns which are located in or are owned in substantial part by project area residence. Regarding employment opportunities for Section 3, the minimum number and job titles are: Minimum Number Job Classification 2 LABORER 1 PLUMBER APPRENTICE I ELECTRICIAN APPRENTICE Regarding job referrals, request that consideration be given, to the greatest extent feasible, to assignment of persons residing in the service area or neighborhood in which the project is located. The anticipated date the work will begin is . For additional information, you may contact ASTRID R. PAYROLL CLERK at ( 909 ) 381-2310 This notice is furnished to you pursuant to the provisions of the above contract or subcontract and Section 3 of the Housing and Urban Development Act of 1968. Copies of this notice will be posted by the undersigned in conspicuous places available to employees or applicants for employment. ROSEMARY PADILLA (Pdm Name) 10/27/2022 (Date) By: (s(s ) PRESIDENT EXHIBIT - 14 SECTION 3 ECONOMIC OPPORTUNITY PLAN (awvn) Business Name BlddeCOContractof DollarAmounl of 64id ❑Contract: Date Plans its to LCA: R DEPENDABLE CONST INC $7-?,9 O �d , 2 Business Address Name of Owner a Aulladzed Agent Sgeature Owneror Au dAg nl 1019 W. 3RD ST., SUITE B, SAN BERNARDINO, CA ROSEMARY PADILLA Local Contracting Agency (LCA): Section 3 coordinator. CoAlacl Information for Sa ' 3 Coordinator. ` CITY OF ROSEMEAD EDDIE CHAN 7149932840 CDBG Project Number Project Name: Project Location: ROSEMEAD PARK RESTROOM RENOVATIONS 4343 ENCINITA AVE., ROSEMEAD, CA 91770 Emplovment&TrainingOpportunities (w ���:wxerlw�newtvnmaernaln�naa�aaed.araa�mneaaReaaeMceo�a nr«mrwaan�wnam WORK CLASSIFICATIONS Of P054io4 Proposed advertising and outreach strategies (seereveneside orNskrmfur ndsranca) Professionals Estimator 1 ADVERTISED ON EMPLOYMENT SEEKING WEBSITES ADVERTISED ON EMPLOYMENT SEEKING WEBSITES ADVERTISED ON EMPLOYMENT SEEKING WEBSITES ADVERTISED ON EMPLOYMENT SEEKING WEBSITES ADVERTISED ON EMPLOYMENT SEEKING WEBSITES ADVERTISED ON EMPLOYMENT SEEKING WEBSITES ADVERTISED ON EMPLOYMENT SEEKING WEBSITES TechnWans orceck., Clerical 2 Trade: Plumbing 1 Trade. Electrical 1 Trade: Trade: Subcontracting Opportunities(auarnacompietedsenan3Business cemec0onformraeach wntrad) Proposed advertising and outreach strategies Name of BUSINESS Basic Trade Type of Contract infer b W Ast ofPW0edsk0*xraz a see reverse$Vs dlNs h(m forassisfaae) YTI ENTERPRISES INC .cru:cF.mwrs.v,nma IZCoastoxMn INVITED DIRECTLY TO BID PROJECT ❑MislCana Wdan conirad INVITED DIRECTLY TO BID PROJECT JAM FIRE PROTECTION FIRE ALARM °Coni" a°n ❑r�on catswo6on conuaa ❑Comuudion l3NonCaaslrWW Canlnd Oconsaucaan 0NonCons1,wW Context ❑co"WOM ❑NwConstnstthn Coneasl ❑Consladion ❑Noo-consWwoncotnd Total Subcontracting Dollars: L$36000 Total amount of Bid:0000 Minimum goal is 25%of the prime contract award 13 e1O EXHIBIT - 14 TRACKING OUTREACH EFFORTS FOR CONTRACTORS Attach supporting documentation foreach 'good failhel/orr'accomplishment Entered into afirst-source hiring agreement with organizations representing Income -qualified residents (such as Work Source Center or San Gabriel Valley Conservation Corps; httOlsnvcorimora! ) and provide the contractor Pmvaie conkaclor with the address of the local Work Source Center, Posted ❑training and/or ❑employment position flyers in; ❑public housing developments (Name orPu6/icHousing_ ❑offices of the local government, fName of once and ❑other conspicuous places — Name a Puce ?/ Advertised positions to be filled through; ❑local media, such as community television networks (Nam ofinedia source ❑newspapers of general circulation, or icommonly-used job placement websites such as www.monster.com (webate used Indeed.com / monster.com / ❑ Contacted an agency administering a HUD Youthbuild Program and requested their assistance to recruit income - qualified participants who are in need of permanent placement. Pro Me confrador with the address of the local Youthbuild Center. Sponsor a HUD-certi(ed "Step -Up° employment and training program for Income -qualified residents. Contacted agencies administering a Section 3 Program for a list of qualified business concerns. fast names below) LABORERS APPRENTICESHIP, AZUSA, CA EXHIBIT - 15 2022 INCOME CERTIFICATION (Section 3 of (he Housing d Urban Developmenl Act of 1968, as amended) Name: ELI VELASCO Address: 712 W. 7TH STREET, POMONA, CA 91766 1 hereby certify that I am (che0 the applicable slalement below): ❑ A Public Housing resident(Specifythe Noma of the Public Housing site); II A low-income resident of the metropolitan area of Los Angeles/Orenge County, based on the following: Check 'Family Size and the gross annual ✓Income from all sources below; FAMILY SIZE INCOME LIMITS 1� $25,050 or less El$25,051 �/ to $41,700 ❑ $41,701 to $66,750 ps $66,751 or more ❑ 2 ❑ $28,600 or less ❑ $28,601 to $47,650 ❑ $47.651 to $76,250 ❑ $76,251 or we ❑ 3 ❑ $32,200 or less ❑ $32,201 to S53,600 ❑ $53,601 to $6500 ❑ $85,801 or more ❑ 4 ❑ $35,750 or less ❑ $35,751 to $59,550 ❑ $52,201 to $95,300 ❑ $95,301 or more ❑ 5 ❑ $38.650 or less ❑ $38.651 to $64.350 ❑ $64.351 to $102,950❑ $102,951 or more[] 6❑ S41,500 or less El $41,501 to$69,100❑ $69,101105110,550❑ $110,551 or me[] 7 ❑ S44,350 or less ❑ $44.351 to $73.850 ❑ $73.851 to $118,200 ❑ SI18,201 or more ❑ 8 ❑ S47,200 or less ❑ $47,201 to $78.650 ❑ $78.651 to $125,800 ❑ S425,801 or more ❑ ❑ Not a public housing or low-income resident of the metropolitan area of Los Angeles/0range County. Certified by signature below, under penalty of perjury under the laws of the State of California; t Wye foregoing is true and correct. ROSEMARY PADILLA 10/27/2022 PIN AdHarm - S.qi f Dale THIS SECTION MUST BE COMPLETED BY THE AUTHORIZED BUSINESS OWNER/AGENT The above -named person Is; []an applicant jj�a permanent full-time ❑ a new -hire employee I Date of hire: ❑WA This persons Work Classification is: PRESIDENT R DEPENDABLE CONST INC ROSEMARY PADILLA 1OP712022 Business Name Pant Name orOwner/Agent Signomi of Owner/Agent Date Name of LCA Pmlecl Name Prclecl Number Income Level: ❑Extremely Low ❑ Very lox ❑ Low ❑ Over the qualifying income knit ❑Not Income qualified for the following mason(s): Preference Category: []Targeted Service Area- Provide census Tied and Block Group []Youth Build Program []McKinney Homeless Program ❑016er qualified Program: Print Name ofSection 3 Coordinafor Signature Date SECTION 3 BUSINESS CERTIFICATION Mtontraclor []Subcontractor Business Name: R DEPENDABLE CONST INC EXHIBIT - 16 M6idor[]ContraclAmount: $290,000.00 Business Address: 10/27/2022 EmailAddress: estimating@rcipconstinc.com The above business concern'Os or pis not a Section 3•quallfted business based on the following: ❑ 51%of this business is owned by Income -qualified resident(s) A completed Resident Cedifrcalion form for each owner must be attached to and submitted with this form. Total number of owners _. Number of Income -qualified owners _ 30%or more, permanent, full-time employees are income -qualified residents A completed Resident Certification form for each employee must be attached to and submitted with this form. Total number of all full-time employees 25 , Numberof income -qualified employees 8 The owner/authorized representative of the above listed business concern certifies under penally of perjury under the laws of the State of California that the foregoing is true and correct. ROSEMARY PADILLA \ PRESIDENT 10/27/2022 Name ofounodpdncipal Signatureof0war n rpal "` True Dare SECTION 3 BUSINESS CONCERN DETERMINATION TO BE COMPLETED By n LOLL CO IaACTwG AGENCY SECTM 3000MNATOR Based on the support documentation submitted for our review, we have delerm'ned that this business concern; Dis or Ols not a qualified business concern, and Odoes or Odces not qualify for a bid preference for the federally -funded construction project denbfied below. CDBG Noted Nunber Project Name Commeras. Local Contracting Agency Section 3 Coordmalor Delool Delemwialbn FEDERAL LOBBYIST CERTIFICATION Name of Firm: R DEPENDABLE CONST INC Address: 1019 W. 3RD STREET, SUITE B, SAN BERNARDINO, CA 02410 State: CA Zip Code: 92410 Telephone Number: ( EXHIBIT -17 909-381-2310 Acting on behalf of the above named firm, as its Authorized Official, I make the following Certification to the U. S. Department of Housing and Urban Development and the Community Development Commission, County of Los Angeles. 1) No Federal appropriated funds have been paid by or on behalf of the above named firm to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of and Federal grant, loan or cooperative agreement, and any extension, continuation, renewal, amendment, or modification thereof, and; 2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee or any agency, a Member of Congress an officer or employee of Congress or an employee of a Member of Congress in connection with this Federal contract, grant loan, or cooperative agreement, the above named firm shall complete and submit Standard Form-LLL, 'Disclosure Form to Report Lobbying", In accordance with its instructions, and; 3) The above name firm shall require that the language of this certification be included in the award documents for all sub -awards at all tiers (including subcontracts, sub -grants, and contracts under grants, loans, and cooperative agreement) and that all sub -recipients shall certify and disclose accordingly. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered Into. Submission of this certification is a prerequisite for making or entering into the transaction imposed by Section 1352 Title 31, U. S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. Authorized Official: R DEPENDABLE CONST INC (Cm1.C(W1SU NOn"n.,) r By: ,ol i 10/27/2022 PRESIDENT R Dependable Construction, Inc. MMIN M INSURANCE REQUIREMENTS Prior to the beginning of and throughout the duration of the Work, Contractor will maintain insurance in conformance with the requirements set forth below. Contractor will use existing coverage to comply with these requirements. If that existing coverage does not meet the requirements set forth here, Contractor agrees to amend, supplement or endorse the existing coverage to do so. Contractor acknowledges that the insurance coverage and policy limits set forth in this section constitute the minimum amount of coverage required. Any insurance proceeds available to City in excess of the limits and coverage required in this Contract and which is applicable to a given loss, will be available to City. Contractor shall provide the following types and amounts of insurance: Commercial General Liability Insurance. Contractor shall maintain commercial general liability insurance with coverage at least as broad as Insurance Services Office form CG 00 01, in an amount not less than $1,000,000 per occurrence, $2,000,000 general aggregate, for bodily injury, personal injury, and property damage, and a $2,000,000 completed operations aggregate. The policy must include contractual liability that has not been amended. Any endorsement restricting standard ISO "insured contract" language will not be accepted. Automobile liability insurance. Contractor shall maintain automobile insurance at least as broad as Insurance Services Office form CA 00 01 covering bodily injury and property damage for all activities of the Contractor arising out of or in connection with Work to be performed under this Agreement, including coverage for any owned, hired, non -owned or rented vehicles, in an amount not less than $1,000,000 combined single limit for each accident. Workers' compensation insurance. Contractor shall maintain Workers' Compensation Insurance (Statutory Limits) and Employer's Liability Insurance (with limits of at least $1,000,000) for Contractor 's employees in accordance with the laws of the State of California, Section 3700 of the Labor Code In addition, Contractor shall require each subcontractor to similarly maintain Workers' Compensation Insurance and Employer's Liability Insurance in accordance with the laws of the State of California, Section 3700 for all of the subcontractor's employees. Excess or Umbrella Liability Insurance. (Over Primary) Contractor shall obtain and maintain an umbrella or excess liability insurance policy that will provide bodily injury, personal injury and property damage liability coverage at least as broad as the primary coverages set forth above, including commercial general liability, automobile liability, and employer's liability. Such policy or policies shall include the following terms and conditions: Contractor shall obtain and maintain an umbrella or excess liability insurance policy that will provide bodily injury, personal injury and property damage liability coverage at least as broad as the primary coverages set forth above, including commercial general liability, automobile liability, and employer's liability. Such policy or policies shall include the following terms and conditions: R Dependable Construction, Inc. • A drop down feature requiring the policy to respond in the event that any primary insurance that would otherwise have applied proves to be uncollectable in whole or in part for any reason; • Pay on behalf of wording as opposed to reimbursement; • Concurrency of effective dates with primary policies; and • Policies shall "follow form" to the underlying primary policies. • Insureds under primary policies shall also be insureds under the umbrella or excess policies. Builder's risk insurance. Upon commencement of construction and with approval of Agency, Contractor shall obtain and maintain builder's risk insurance for the entire duration of the Project until only the Agency has an insurable interest. The Builder's Risk coverage shall include the coverages as specified below. The named insureds shall be Contractor and Agency, including its officers, officials, employees, and agents. All Subcontractors (excluding those solely responsible for design Work) of any tier and suppliers shall be included as additional insureds as their interests may appear. Contractor shall not be required to maintain property insurance for any portion of the Project following transfer of control thereof to Agency. The policy shall contain a provision that all proceeds from the builder's risk policy shall be made payable to the Agency. The Agency will act as a fiduciary for all other interests in the Project. Policy shall be provided for replacement value on an "all risk" basis forthe completed value of the project. There shall be no coinsurance penalty or provisional limit provision in any such policy. Policy must include: (1) coverage for any ensuing loss from faulty workmanship, Nonconforming Work, omission or deficiency in design or specifications; (2) coverage against machinery accidents and operational testing; (3) coverage for removal of debris, and insuring the buildings, structures, machinery, equipment, materials, facilities, fixtures and all other properties constituting a part of the Project; (4) Ordinance or law coverage for contingent rebuilding, demolition, and increased costs of construction; (5) transit coverage (unless insured by the supplier or receiving contractor), with sub -limits sufficient to insure the full replacement value of any key equipment item; (6) Ocean marine cargo coverage insuring any Project materials or supplies, if applicable; (7) coverage with sub -limits sufficient to insure the full replacement value of any property or equipment stored either on or off the Site or any staging area. Such insurance shall be on a form acceptable to Agency to ensure adequacy of terms and sublimits and shall be submitted to the Agency prior to commencement of construction. Insurance procured pursuant to these requirements shall be written by insurers that are admitted carriers in the state of California and with an A.M. Bests rating of A- orbetter and a minimum financial size VII. General conditions pertaining to provision of insurance coverage by Contractor. Contractor and City agree to the following with respect to insurance provided by Contractor: 1. Contractor agrees to have its insurer endorse the third party General liability policies shall provide or be endorsed to provide that Agency and its officers, officials, employees, agents, and volunteers shall be additional insurer under such policies R Dependable Construction, Inc. using standard ISO endorsement No. CG 2010.. Contractor also agrees to require all contractors. and subcontractors to do likewise. 2. No liability insurance coverage provided to comply with this Contract shall prohibit Contractor, or Contractor's employees, or agents, from waiving the right of subrogation prior to a loss. Contractor agrees to waive subrogation rights against City regardless of the applicability of any insurance proceeds, and to require all contractors and subcontractors to do likewise. 3. All insurance coverage and limits provided by Contractor and available or applicable to this Contract are intended to apply to the full extent of the policies. Nothing contained in this Contract or any other Contract relating to the City or its operations limits the application of such insurance coverage. 4. None of the coverage required herein will be in compliance with these requirements if they include any limiting endorsement of any kind that has not been first submitted to City and approved of in writing. 5. No liability policy shall contain any provision or definition that would serve to eliminate so-called "third party action over" claims, including any exclusion for bodily injury to an employee of the insured or of any contractor or subcontractor. 6. All coverage types and limits required are subject to approval, modification and additional requirements by the City, as the need arises. Contractor shall not make any reductions in scope of coverage (e.g. elimination of contractual liability or reduction of discovery period) that may affect City's protection without City's prior written consent. 7. Proof of compliance with these insurance requirements, consisting of certificates of insurance evidencing all of the coverage required and an additional insured endorsement to Contractor's general liability policy, shall be delivered to City at or prior to the execution of this Contract. In the event such proof of any insurance is not delivered as required, or in the event such insurance is canceled at any time and no replacement coverage is provided, City has the right, but not the duty, to obtain any insurance it deems necessary to protect its interests under this or any other Contract and to pay the premium. Any premium so paid by City shall be charged to and promptly paid by Contractor or deducted from sums due Contractor, at City option. 8. Certificate(s) are to reflect that the insurer will provide 30 days notice to City of any cancellation of coverage. Contractor agrees to require its insurer to modify such certificates to delete any exculpatory wording stating that failure of the insurer to mail written notice of cancellation imposes no obligation, or that any party will "endeavor" (as opposed to being required) to comply with the requirements of the certificate. R Dependable Construction, Inc. 9. It is acknowledged by the parties of this Contract that all insurance coverage required to be provided by Contractor or any subcontractor, is intended to apply first and on a primary, noncontributing basis in relation to any other insurance or self insurance available to City. 10. Contractor agrees to ensure that subcontractors, and any other party involved with the project who is brought onto or involved in the project by Contractor, provide the same minimum insurance coverage required of Contractor. Contractor agrees to monitor and review all such coverage and assumes all responsibility for ensuring that such coverage is provided in conformity with the requirements of this section. Contractor agrees that upon request, all Contracts with subcontractors and others engaged in the project will be submitted to City for review. 11. Contractor agrees not to self -insure or to use any self -insured retentions or deductibles on any portion of the insurance required herein and further agrees that it will not allow any contractor, subcontractor, Architect, Engineer or other entity or person in anyway involved in the performance of work on the project contemplated by this Contract to self -insure its obligations to City. If Contractor's existing coverage includes a deductible or self -insured retention, the deductible or self - insured retention must be declared to the City. At that time the City shall review options with the Contractor, which may include reduction or elimination of the deductible or self -insured retention, substitution of other coverage, or other solutions. 12. The City reserves the right at any time during the term of the contract to change the amounts and types of insurance required by giving the Contractor ninety (90) days advance written notice of such change. If such change results in substantial additional cost to the Contractor, the City will negotiate additional compensation proportional to the increased benefit to City. 13. For purposes of applying insurance coverage only, this Contract will be deemed to have been executed immediately upon any party hereto taking any steps that can be deemed to be in furtherance of or towards performance of this Contract. 14. Contractor acknowledges and agrees that any actual or alleged failure on the part of City to inform Contractor of non-compliance with any insurance requirement in no way imposes any additional obligations on City nor does it waive any rights hereunder in this or any other regard. 15.Contractor will renew the required coverage annually as long as City, or its employees or agents face an exposure from operations of any type pursuant to this Contract. This obligation applies whether or not the Contract is canceled or terminated for any reason. Termination of this obligation is not effective until City executes a written statement to that effect. 16.Contractor shall provide proof that policies of insurance required herein expiring during the term of this Contract have been renewed or replaced with other policies providing at least the same coverage. Proof that such coverage has been ordered R Dependable Construction, Inc. shall be submitted prior to expiration. A coverage binder or letter from Contractor's insurance agent to this effect is acceptable. A certificate of insurance and/or additional insured endorsement as required in these specifications applicable to the renewing or new coverage must be provided to City within five days of the expiration of the coverage. 17.The provisions of any workers' compensation or similar act will not limit the obligations of Contractor under this Contract. Contractor expressly agrees not to use any statutory immunity defenses under such laws with respect to City, its employees, officials and agents. 18. Requirements of specific coverage features or limits contained in this section are not intended as limitations on coverage, limits or other requirements nor as a waiver of any coverage normally provided by any given policy. Specific reference to a given coverage feature is for purposes of clarification only as it pertains to a given issue, and is not intended by any party or insured to be limiting or all-inclusive. 19.These insurance requirements are intended to be separate and distinct from any other provision in this Contract and are intended by the parties here to be interpreted as such. 20. The requirements in this Section supersede all other sections and provisions of this Contract to the extent that any other section or provision conflicts with or impairs the provisions of this Section. 21. Contractor agrees to be responsible for ensuring that no contract used by any party involved in any way with the project reserves the right to charge City or Contractor for the cost of additional insurance coverage required by this Contract. Any such provisions are to be deleted with reference to City. It is not the intent of City to reimburse any third party for the cost of complying with these requirements. There shall be no recourse against City for payment of premiums or other amounts with respect thereto. Contractor agrees to provide immediate notice to City of any claim or loss against Contractor arising out of the work performed under this Contract. City assumes no obligation or liability by such notice, but has the right (but not the duty) to monitor the handling of any such claim or claims if they are likely to involve City. CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDNYYY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Diamond Valley Insurance Services, Inc. NAME; Stephanie M. CoronadoPHONE EAIX 41856 Ivy Street # 108 E-MAIL 01 (961)553-7400 (AIC, No): (951)296-6808 MURRIETA, CA 92562 ADDRESS. stephanla@diamondvalleylns.com License #: OH94716 ..-- INSURER(S) AFFORDING COVERAGE _. ( ,.-NAICN INSURER A: Great American E&S Ins. Co. 137532 INSURED mgimrRR, AmGUard Insurance Comoanv 142390 R DEPENDABLE CONSTRUCTION, INC. 1019 W 3RD STREET, STE B SAN BERNARDINO, CA 92410 INSURERE: I Indian Harbor Insurance Company 1^k'1MeA^MQ ---- neormlcATE NUMBER' nnnn1A1A.n REVISION NUMBER: 1 v THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS -- - INSRADDLSUBR - .- -- POLICY EFF POLICY EXP LIMITS LTR TYPE OFIN S URANCE POLICYNUMBER iMMIDDIYYYYI (MMIDDNYYYI A X COMMERCIAL GENERAL LIABILITY E732680 0611712022 0611712023 EACH OCCURRENCE _ S 19000,000 ICLAIMS-AWDE I X.OCCUR DAMAGETO RENTED PREMISES (Ea occurrence)._. S-100,000 HIED EXP(Any one person)_. $ 5,000 PERSONAL &ADVINJURY $ 1,000,000 GENL AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ _2,000,000 X POLICYI ) PR JECOT -I LOC PRODUCTS-COMP/OP AGO_ $ 2,000,090 OTHER: B AUTOMOBILE LIABILITY RDAU345955 0310212022 03/0212023 (Eaaocident) $ 1,000,000 X ANY AUTO BODILY INJURY (Per person) S ,. -'. OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS ONLY ,AUTOS " HIRED NON -OWNED PROPERTY .. $ AUTOS ONLY ..... AUTOS ONLY (Peraccident) --. `• XIUMBRELLALIAB X OCCUR M87959220ALI 06/1712022 06/1712023 EACH OCCURRENCE $ 5,000,000 {( EXCESS LIAR CLAIMS-MeDE AGGREGATE $ 5,000,000 RETENTIONS $ D WORKERS COMPENSATION 906484621 0710312022 0710312023 STATDED X LITE EVR -. AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNEFUEXECUTIVE Y/N NIA' EL EACH ACCIDENT $ 1,000,000 OFFIC000EMBER EXCLUDED? (Mandatory In NH) EL DISEASE -EAE"PLOYEE S 1,000,000 Ifyes, describe antler OF OPERATIONS below+ E.L. DISEASE - POLICY LIMIT $ 1,000,000 E .DESCRIPTION Builders Risk SL 2916493 01/0212023 03/0212023 New Structures CDC 290,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached it more space is required) RE: Project No. 39003 Rosemead Park Restreom Renovations Project located at 343 Enclnita Avenue, Rosemead CA 91770. 30 Days Notice of Intent to Cancel, Except 10 days for Non Payment of Premium. rtAMrolIATMIJ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Rosemead ACCORDANCE WITH THE POLICY PROVISIONS. 8838 E. Valley Blvd AUTHORIZED REPRESENTATIVE Rosemead, CA 91770 O'X" —� (SMC) U 196 AUUKU GUKrUKA I IWN. All rigri reset VeO ACORD 2512016/031 The ACORD name and loao are reaistered marks f AC D Printed by SAIC on 12/20/2022 at 02:25PNI GLS 50 07 (Ed. 11 19) GiIiLAI 30TE 4-St..[ AMBRICAN, aoie 4usl�ael INSURANCE GROUP Cmmne0. 0h45202 Tel: 1-513369-5000 This endorsement, effective 12.01 a.m., 6/1712022 forms a part of Policy No. E732680 issued to R Dependable Construction By GREAT AMERICAN E&S INSURANCE COMPANY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED -BLANKET WHEN REQUIRED BY CONTRACT- COVERAGE E1 This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART Solely with regard to all Coverage E1, SECTION II — WHO IS AN INSURED is amended by the addition of the following: 5. When required by written contract, any person or organization that is unrelated to you, but only if that contract was signed by you prior to the date you commenced "your work" and then solely to the extent that such person or organization is found liable based upon "your work" that was negligently performed by an insured other than such person or organization. No coverage will be provided under this Policy for the such person's or organization's own negligence. All other terms and conditions remain the same. POLICY NUMBER: E732680 COMMERCIAL GENERAL LIABILITY GLE 20 10 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM WITH BROADENING ENDORSEMENT AND POLLUTION LIABILITY COVERAGE SCHEDULE Name Of Additional Insured Person(s) Or Organ zations Location(s) Of Covered Operations Any person or organization for whom you are performing In respect to any location where the named insured is operations when you and such person or organization performing "your work". nave agreed in writing in a contract or agreement, affected prior to the date your operations for that person r organization commenced, that such person or rganization be added as an additional insured on your licy. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II - Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. However: 2. 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or That portion of 'your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. GLE 2010 04 13 0 Insurance Services Office, Inc., 2012 Page 1 of 2 C. With respect to the insurance afforded to these additional insureds, the following is added to Section III - Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. GLE 2010 04 13 0 Insurance Services Office, Inc., 2012 Page 2 of 2 9i1a14 VA►Lai IT, 1 10a:0 Z 1151cY3YZ7 COMMERCIAL GENERAL LIABILITY GLE 20 37 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM WITH BROADENING ENDORSEMENT AND POLLUTION LIABILITY COVERAGE SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location And Description Of Completed Operations ny person or organization for whom you are performing In respect to any location where the named insured is Aerations when you and such person or organization performing "your work. ave agreed in writing in a contract or agreement, ffected prior to the date your operations for that person organization commenced, that such person or rganization be added as an additional insured on your lic . Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II - Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by 'your work' at the location designated and described in the Schedule of this endorsement performed for that additional insured and included in the "products -completed operations hazard". However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following is added to Section III - Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. GLE 20 37 0413 0 Insurance Services Office, Inc., 2012 Page 1 of 1 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY/NON-CONTRIBUTORY COVERAGE NAMED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM WITH BROADENING ENDORSEMENT AND POLLUTION LIABILITY COVERAGE PR I MARYINON-CONTRI BU TORY —If required by written contractor agreement, effective prior to the date your operations for that person or organization commenced and named below, such insurance as is afforded by this policy to any additional insureds underthis policy shall be primary insurance, and any insurance or self-insurance maintained by such additional insured(s) shall not contribute to the insurance afforded to the named insured. All other terms and conditions remain unchanged. SCHEDULE Name of Person or Organization: 1. An owner of real a personal property on which you are performing operalions,but only at the specific written request by that person a organization to you, and only if: a. That request is made prior lothe date your operations forthat person a organization commenced: and b. ACertificate of Insurance evidencing that request has been issued byyour authorized insurance agent or broker; a 2. A contractor on whose behalf you are performing operations, but only at the specificwritten request bythat person a organization to you, and only if: a. That request is made prior tothe date your operations for that person or organization commenced; and b. ACerlifcate of Insurance evidencing that request has been issued byyour authorized insurance agent or broker. GLE 50 0612 19 Includes copyrighted material of Insurance Services Office, Inc. Page 1 of 1 with its permission POLICY NUMBER: E732680 COMMERCIAL GENERAL LIABILITY GLE 24 04 05 09 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM WITH BROADENING ENDORSEMENT AND POLLUTION LIABILITY COVERAGE SCHEDULE Name Of Person Or Organization: 1. An owner of real or personal property on which you are performing operations, but only at the specific written request by that person or organization to you, and only if. a. That request is made priorto the date your operations forthat person ororganization commenced; and b. A Certificate of Insurance evidencing that request has been issued by yourauthorized insurance agent or broker; or 2. A contractor on whose behalf you are performing operations, but only at the specific written request by that person or organization to you, and only if: a. That request is made prior to the date your operations forthat person ororganization commenced, and b. A Certificate of Insurance evidencing that request has been issued by yourauthorized insurance Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV —Conditions: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or 'your work" done under a contract with that person or organization and included in the "products - completed operations hazard". This waiver applies only to the person or organization shown in the Schedule above. GLE 24 04 05 09 © Insurance Services Office, Inc., 2008 Page 1 of 1 ENDORSEMENT AGREEMENT WAIVER OF SUBROGATION BLANKET BASIS HOME OFFICE SANFRANCISCO EFFECTIVE JULY 3, 2022 AT 12.01 A.M. ALLEFFECTIVE DATESARE AND EXPIRING JULY 3, 2023 AT 12.01 A.M. AT 12:01 AM PACIFIC STANDARD TIME OR THE TIME INDICATED AT PACIFIC STANDARD TIME R DEPENDABLE 1019 W 3RD ST SAN BERNARDINO, CA 92410 WE HAVE THE RIGHT TO RECOVER OUR PAYMENTS FROM ANYONE LIABLE FOR AN INJURY COVERED BY THIS POLICY. WE WILL NOT ENFORCE OUR RIGHT AGAINST THE PERSON OR ORGANIZATION NAMED IN THE SCHEDULE. THIS AGREEMENT APPLIES ONLY TO THE EXTENT THAT YOU PERFORM WORK UNDER A WRITTEN CONTRACT THAT REQUIRES YOU TO OBTAIN THIS AGREEMENT FROM US. THE ADDITIONAL PREMIUM FOR THIS ENDORSEMENT SHALL BE 2.00% OF THE TUTAL POLICY PREMIUM. SCHEDULE PERSON OR ORGANIZATION ANY PERSON OR ORGANIZATION FOR WHOM THE NAMED INSURED HAS AGREED BY WRITTEN CONTRACT TO FURNISH THIS WAIVER JOB DESCRIPTION BLANKET WAIVER OF SUBROGATION REP D3 9064846-22 RENEWAL NA 5-37-32-44 PAGE 1 OF 1 NOTHING IN THIS ENDORSEMENT CONTAINED SHALL BE HELD TO VARY, ALTER, WAIVE OR EXTEND ANY OF THE TERMS, CONDITIONS, AGREEMENTS, OR LIMITATIONS OF THIS POLICY OTHER THAN AS STATED. NOTHING ELSEWHERE IN THIS POLICY SHALL BE HELD TO VARY, ALTER, WAIVE OR LIMIT THE TERMS, CONDITIONS, AGREEMENTS OR LIMITATIONS OF THIS ENDORSEMENT. COUNTERSIGNED AND ISSUED AT SSA�N rRRANCISCO: 2572 AUTHORIZED REPRESENT IVE SCIF FORM 10217 (irEV.7-2014) JULY 6, 2022 PRESIDENT AND CEO OLD DP 217 CITY OF ROSEMEAD ROSEMEAD PARK RESTROOM RENOVATION PROJECT PROJECT No. 39003 PERFORMANCE BOND Bond#18L005751 Premium: $7,540 PERFORMANCE BOND WHEREAS the CITY OF ROSEMEAD (also herein "Obligee") has awarded to R Dependable Const Inc (hereinafter "Cortractor"), a contract for work consisting of but not limited to, furnishing all labor, materials, tools, equipment, services, and incidentals for the ROSEMEAD PARK RESTROOM RENOVATION PROJECT and all other required structures and facilities -,within the rights -of -way, easements and permits; WHEREAS, the Work to be performed by the Contractor is more particularly set forth in that certain contract for the said Public Work dated December 13, 2022 (hereinafter the "Public Work Contract"); and WHEREAS, the Contractor is required by said Public Work Contract to perform the terms thereof and to provide a bond both for the performance and guaranty thereof, NOW, THEREFORE, we R Dependable Const Inc , die undersigned Contactor, as Principal, and The Ohio Casualty Insurance Company a corporation organized and existing under the laws of the State of New Hampshire and duly authorized to transact business raider the laws of the State of California, as Stuety, are held and fruity bound unto the CiTY OF ROSEMEAD in the sum of Two Hundred Ninety Thousand Dollars and no/100 dollars, is 290,000.00 ), said sum being not less than 100% of tie total amount payable by the said Obligee under the terns of the said Public Work Contract, for which payment well and truly to be made, we bind ourselves, our heirs, executors and administrators, successors and assigns, jointly and severally, firmly by these presents. THE CONDITION OF THiS OBLIGATION iS SUCH, that if the Principal, his or its heirs, executors, administrators, successors or assigns, shall in all things stand to and abide by, and well and truly keep and perform the covenants, conditions and agreements in the said Public Work Contract and any alteration thereof made as therein provided, on his or their part, to be kept and performed at the tine and in the manner therein specified, and in all respects according to their intent and meaning; and shall faithfully fultitl the one-year guarantee of all materials and workmanship; and indemnify and save harmless the Obligee, its officers and agents, as stipulated in the said Public Work Contract, then this obligation shall beconhenull and void; otherwise it shall be and remain in full force and effect. in the event legal action is required to enforce the provisions of this agreement, the prevailing party shall be entitled to recover reasonable attorneys' fees in addition to court costs, necessary disbursements, and other damages. in case legal action is required to enforce the provisions of this bond, the prevailing party shall be entitled to recover reasonable attorneys' fees in addition to court costs, necessary disbursements and other consequential damages. The said Surety, for value received, hereby stipulates and agrees that no change, extensions of time, alteration or addition to the terms of the Public Work Contract or to the Work PERFORMANCE BOND-1 to be pertonncd thereunder, or the specifications accompanying the same shall in any way aticct its obligations on this bond, and it does hereby waive notice of any such change, extension of time, alteration or addition to the terms of the Contract, or to the Work or to Specifications. IN WITNESS WHEREOF, we have hereto set our hands and seals this 21st day on December , 20 22 R Dependable Const Inc principal/C o n trac to r t By: Waz resident o ary Padilla The Ohio Casualty Insurance Company Surety By: CLLo Attorney -in- act Ashley N. Baker The rate of premium on this bond is $26.00 per thousind. The WWI atnotutt of pi charged, $ 7,540 (The above must be filled in by corporate surety.) STATE OF CALIFORNTA ) ss. COUNTY OF 1 On this _ day of , in the year , before me, a Notary Public in and for said state, personally appeared , knomi to me (or proved to be on the basis of satisfactory evidence) to be the person whose name is subscribed to the within insnvment as the Attorney -in -Fact of the (surety) and acknowledged to me that he subscribed the name of the (surety) thereto and his own name as Attorney -in -Fact. (SEAL) My Commission expires ATTACHED Notary Public in and for said State PERFORMANCE BOND-3 CERTIFICATE AS TO CORPORATE PRINCIPAL I, Rosemary Padilla , certify that I am the Corporate Secretary of the corporation named as principal to the within bond; that Rosemary Padilla who signed the said bond on behalf of the principal was then Rosemary Padilla of said corporation; that I know his signature, and his signature thereto is genuine; and that said bond was duly signed, sealed and attested for and in behalf of said corporation by authority of its governing Board. } (Corporate Seal) Signature 12/22/2022 Date NOTE: A copy of the power of attorney to local representatives of the bonding company may be attached hereto. PERFORMANCE BOND - 4 CALIFORNIA ALL-PURPOSE CERTIFICATE OF ACKNOWLEDGMENT A notary public or other officer completing this certificate verifies only the identity of the individual who signed' the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of San Bernardino On Lcc before me, Beatriz A. Corona -Torres (Here insert name and title of the officer) personally appeared Rosemary Padilla who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. �_6-C)M,0/\-4-, J(W"Q Signature of Notary Public BEATR CORONA-TORRES Notary Public - California QOP� Riveiverside County(Notary Seal)Commission I7 2321354 y Comm. Expires Feb 13. 2024 ADDITIONAL OPTIONAL INFOILMATION DESCRIPTION OF THE ATTACHED DOCUMENT ��rC�rmc�h C-e ►3Ch (Title or description of attached document) (Title or description of attached document continued) Number of Pages Document Date I2IZ112� (Additional information) CAPACITY CLAIMED BY THE SIGNER ❑ Individual (s) ❑ Corporate Officer (Title) ❑ Partner(s) ❑ Attomey-in-Fact ❑ Trustee(s) ❑ Other INSTRUCTIONS FOR COMPLETING THIS FORM Any acknowledgment completed in California must contain verbiage eractiv as appears above in the notary section or a separate acknowledgment form must be properly completed and attached to that document The oary exception is if a document is to be recorded outside of California. In such instances, any alternative acknowledgment verbiage as may be printed on such a document so long as the verbiage does not require the notary to do something that is illegal for a notay in California (i.e. certifying the authorized capacity of the signer). Please check the document carefully for proper notarial wording and attach this form if required. • State and County information must be the State and County where the document signer(s) personally appeared before the notary public for acknowledgment. • Date of notarization must be the date that the signer(s) personally appeared which must also be the same date the acknowledgment is completed. • The notary public must print his or her name as it appears within his or her commission followed by a comma and then your title (notary public). • Print the name(s) of document signer(s) who personally appear at the time of notarization. • Indicate the career singular or plural forms by crossing off incorrect forms (i.e. he/she/they,— is /are ) or circling the correct forms. Failure to correctly indicate this information may lead to rejection of document recording. • The notary seal impression must be clear and photographically reproducible. Impression must not cover text or lines. If seal impression smudges, re -seal if a sufficient area permits, otherwise complete a different acknowledgment form. • Signature of the notary public must match the signature on file with the office of the county clerk. -e Additional information is not required but could help to ensure this acknowledgment is not misused or attached to a different document. Indicate title or type of attached document, number of pages and date. Indicate the capacity claimed by the signer. If the claimed capacity is a corporate officer, indicate the title (i.e. CEO, CFO, Secretary). • Securely attach this document to the signed document 2008 Version CAPA vl2.10.07 800-873-9865 www.NotaryC]asses.com oQtum erty . SURETY This Power of Attorney limits the acts of those named herein, and they have no authority to bind the Company except in The manner and to the extent herein staled. Liberty Mutual Insurance Company The Ohio Casualty Insurance Company West American Insurance Company POWER OF ATTORNEY Certificate No: 8208023.987721 KNOWN ALL PERSONS BY THESE PRESENTS: That The Ohio Casualty Insurance Company is a corporation duly organized under the laws of the Stale of New Hampshire, that Liberty Mutual Insurance Company is a corporation duly organized under the laws of the Slate of Massachusetts, and West American Insurance Company is a corporation duly organzed under the laws of the Stale of Indiana (herein collectively called the 'Companies ), pursuant to and by authority herein set forth, dos hereby name, constitute and appoint, Ashley N. Baker. Karen A. Ebv. Kvle T. Baker. Timothv C. Baker all of the city of blurrieta stale of CA each individually if mere be more than one named, its true and lawful attorney -in -fact to make, execute, seal, acknowledge and deliver fa and on its behalf as surety and as its act and deed, any and all undertakings, bonds, recognizancs and other surety obligations, in pursuance of these presents and shall be as binding upon the Companies as if they have been duly signed by the president and attested by the secretary of the Companies in their on proper persons. IN WITNESS WHEREOF, this Power of Attorney has been subscribed by an authorized officer or official of the Companies and the corporate seals of the Companies have been affixed [hereto this Ilth dayof May , 2022 . :NNSYLVANIA MONTGOMERY Liberty Mutual Insurance Company tiJP� aeory�yo yJP�oavo��'Pgy oP�a voaq�2e, Wst American Insurance CompThe Ohio Casualty Insurance any 3 y�a1912 S o 1919m, f 1991� a ti' a4CNUfia LtwAYVUa a Ys �NDIANP da 1 yh t NtSa yH1 • Ktla dM • F� By: 4- David M. Carey, Assistant Secretary I Ith day of May , 2022 before me personally appeared David M. Carey, who acknovdedged himself to be the Assistant Secretary of Liberty Mutual Insurance The Ohio Casualty Company, and West American Insurance Company, and that he, as such, being authorized so to do, execute the foregoing instrument for the purposes stained by signing on behalf of the corporations by himself as a duly authorized officer. SS WHEREOF, I have hereunto subscribed my name and affixed my notarial seal at King of Prussia, Pennsylvania, on the day and year first above written. 9P PA3T Qx4 Y°xWE F! Canna,weaxh dPervYyMaNa-Ndary Seal �1 N�rpd 4<1 Cy TBRH PaSIMd.Nday Pubrit � y// _ Mm(gon�ery0aunty /!i/lU/•✓-/(�L�'r//it/,-/P�/, OF My canmYsbn eWE Maid, 28,2025 By; A�W>`°P ,Pen%*ama berl128U ,y, �,,,�,. aen.,�yw,d,7YsvdanY,wxvYava Teresa Paslctla, Notary Public Aqy W`'� r of Attorney is made and executed pursuant to and by authority of the following By-laws and Authorizations of The Ohio Casualty Insurance Company, Liberty Mutual Company, and West American Insurance Company which resolutions are now in full force and effect reading as follows: ICLE IV —OFFICERS: Section 12. Power of Attorney. officer or other official of the Corporation authorized for that purpose in writing by the Chairman or the President, and subject to such limitation as the Chairman a the idenl may prescribe, shall appoint such allomeys-in-fact, as may be necessary to act in behalf of the Coporalion to make, execute, seal, acknowledge and deliver as surely and all undertakings, bonds, reeognizancs and other surely obligations. Such attorneys -in -fad, subject to the limitations set forth in their respective powers of attorney, shall full power to bind the Corporation by their signature and execution of any such instruments and to attach thereto the seal of the Corporation. When so executed, such uments shall be as binding as if signed by the President and attested to by the Secretary. Any power or authority granted to any representative a allomey-in-fact under the isions of this ar6cte may be revoked at any time by the Board, the Chairman, the President or by the officer or officers granting such power a authority. ICLE All — Execution of Contracts: Section 5. Surely Bonds and Undertakings. officer of the Company authorized for that purpose in writing by the chairman or the president, and subject to such limitations as the chairman or the president may prescribe, appoint such attomeys-in-fact, as may be necessary to act in behalf of vie Company to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety obligations. Such attomeys-in-fact subject to the limitations set forth in their respective powers of attorney, shall have full power to bind the Company by their signature and execution of any such instruments and to attach thereto the seal of the Company. When so executed such instruments shall be as binding as if signed by the president and attested by the secretary. Certificate of Designation — The President of the Company, acting pursuant to the Bylaws of the Company, authorizes David M. Carey, Assstanl Secretary to appoint such attomeys-in- fact as may be necessary to act on behalf of the Company to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizanees and other surety obligations. Authorization — By unanimous consent of the Companys Board of Directors, the Company consents that facsimile or mechanically reproduced signature of any assistant secretary of the Company, wherever appearing upon a certified copy of any power of attorney issued by the Company in connection with surety bonds, shall be valid and binding upon the Company with the same force and effect as though manually affixed. I, Renee C. Llewellyn, the undersigned, Assistant Secretary, The Ohio Casualty Insurance Company, Liberty Mutual Insurance Company, and West American Insurance Company do hereby certify that the original power of attorney of which the foregoing is a full, true and correct copy of the Power of Attorney executed by said Companies, is in full face and effect and has not been revoked. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seals of said Companies this 21st day of December , 2022 . c)(90 "°e"q�R9ip0' o"v°"+�yoFa m�3``o m919 E 1991moa o wgYvs�ada rsyrxo,AYPada$ By Renee C. Llewellyn, Assistant Secretary LMS-12873 LMIC OCIC WAIC Mum Co 02/2i CALIFORNIA ALL- PURPOSE CERTIFICATE OF ACKNOWLEDGMENT A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of Riverside ) Onbefore me, K. A. Eby, Notary Public {Here ms¢m mama one IEI¢ of lh¢ of ceq personally appeared Ashley N. Baker who proved to me on the basis of satisfactory evidence to be the person(s) whose na I ale subscribed to the within instrument and acknowledged to me that s ley executed the same in tj��t rr eir authorized capacity(�s), and that by ,hi'�ir signatureW on the instrument the persona, or the entity upon behalf of which the perso%sfacted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. SWITNES my hand a eat. K•A•EllCMM. N233369-3 —iu'vro .arKe..FLI1NNIIIVEp514L COUNTY V [emm. E•plro SryiCNnER ut A)• Notary P tic Signature (Notary Public Seal) fe1 T PTION OF THE ATTACHED DOCUMENT or description of attached document) ascription of attached document continued) of Pages Document Date CAPACITY CLAIMED BY THE SIGNER ❑ Individual (s) ❑ Corporate Officer (Title) ❑ Partner(s) ❑ Attorney -in -Fact ❑ Trustee(s) ❑ Other INSTRiJCTIONS FOR COMPLETING THIS FORAM Thisfarm complies with current California statutes regarding notary wording mid, if needed should be conipieted mid attached to the document. Aclatoidedgments front other states nary be completed for documents being sent to that state so long as the wording does not require the Cahfomia nolmyto violate Califonda noiary IMF. • Stale and County infomratidn must be the Stale and County where the document signer(s) personally appeared before the notary public for acknowledgment. • Dale of notarization must be the dale that the signer(s) personally appeared which must also be the same date the acknowledgment is completed. • •ihe notary public must print his or her time as it appears within his or her commission followed by a comma and that your title (notary public). • Print the name(s) of document signer(s) who personally appear at the time of notarization. • Indicate the correct singular or plural forms by crossing off incorrect forms (i.e. IWshei'ntey- is /ars) or circling the correct forms. Failure to correctly indicate this information may lead to rejection of document recording. • The notary seal impression must be clear and photographically reproducible. Impression must not cover lest or lines. ff seal impression smudges, re -seal if a sufficient area permits, otherwise complete a different acknowledgment form. • Signature of the notary public must match the signature on file with the office of the county dark. Additional information is not required but could help to ensure this acknowledgment is not misused or attached to a different document. Indicate title or type of attached document, number of pages and dale. . Indicate the capacity claimed by the signer. If the claimed opacity is a corporate officer, indicate the title (i.e. CEO, CFO, Secretary). • Securely attach this document to the signed document with a staple. CITY OF ROSEMEAD ROSEMEAD PARK RESTROOM RENOVATION PROJECT PROJECT No. 39003 PAYMENT BOND Bond# 181.005751 PAYMENT (MATERIAL & LABOR) BOND WHEREAS the CITY OF ROSEMEAD (hereinafter "Obligee") has awarded to R Dependable Const Inc (hereinafter "Contractor"), a contract for work consisting of but not limited to, finnisbing all labor, materials, tools, equipment, services, and incidentals for the ROSEMEAD PARK RESTROOM RENOVATION PROJECT and all other required structures and facilities within the rights -of -way, easements and permits; WHEREAS, the Work to be performed by the Contractor is more particularly set forth in that certain contract for the said Public Work dated December 13, 2022 (hereinafter the "Public Work Contract"); and WHEREAS, said Contractor is required to furnish a bond in connection with said Public Work Contract providing that if said Contractor or any of his or its subcontractors shall tail to pay for any materials, provisions, or other supplies, or terms used in, upon, for or about the performance of the Work contracted to be done, or for any work or labor done thereon of any kind, or for amounts due under the provisions of 3248 of the California Civil Code, with respect to such work or labor, that the Surety on this bond will pay the same together with a reasonable attorney's fee in case suit is brought on the bond. NOW, THEREFORE, we R Dependable Const Inc , the undersigned Contractor, as Principal and The Ohio Casualty Insurance Company , a corporation organized and existing under the laws of the State of New Hampshire and duly authorized to transact business under the laws of the State of California, as Surety, are held and firmly bound unto the CiTY OF ROSEMEAD and to any and all material men, persons, companies or corporations furnishing materials, provisions, and other supplies used in, upon, for or about the performance of the said Public Work, and all persons, companies or corporations renting or hiring teams, or implements or machinery, for or contributing to said Public Work to be done, and all persons performing work or labor upon the same and all persons supplying both work and materials as aforesaid excepting the said Contractor, the suns of Two Hundred Ninety Thousand Dollars and no/100 dollars, ($ 290,000,00 ), said sum being not less than 100% of the total amount payable by said Obligee under the terms of the said Public Work Contract, for which payment well and truly to be made, we bind ourselves, our heirs, executors and administrators, successors and assigns jointly and severally, firmly by these presents. THE CONDITION OF THiS OBLIGATION iS SUCH that if the Principal, his or its subcontractors, heirs, executors, administrators, successes, or assigns, shall fail to pay for any materials, provisions, or other supplies or machinery used in, upon, for or about the performance of the Work contracted to be done, or for work or labor thereon of any kind, or fail to pay any of the persons named in California Civil Code Section 3181, or amounts due under the Unemployment Insurance Code with respect to work or labor performed by any such claimant, or for any amounts required to be deducted, withheld, and paid over to the Employment Development PAYMENT BOND - I Department fiom the wages of employees of the contractor and his subcontractors pursuant to Section 13020 of the Unemployment Insurance Code with respect to such work and labor, and all other applicable laws of the State of California and rules and regulations of its agencies, then said Surety will pay the same in or to an amount not exceeding the sum specified herein. In case legal action is required to enforce the provisions of this bond, the prevailing patty shall be entitled to recover reasonable attorneys' tees in addition to court costs, necessary disbursements and other consequential damages. Tn addition to the provisions hereinabove, it is agreed that this bond will inure to the benefit of any and all persons, companies and corporations entitled to make claims under Sections 3110, 31 1 I, 1112 and 31 S 1 of the California Civil Code, so as to give a right of action to them or their assigns in any suit brought upon this bond. The said Surety, For value received, hereby stipulates and agrees that no change, extension of time, alteration or additions to the terms of the said Public Work Contract or to the Work to be performed thereunder or the specification accompanying the same shall in any way affect its obligations on this bond, and it does hereby waive notice of any such change, extension of time, alteration or addition to the terms of the Contract or to the Work or to the Specifications. TN WTTNGSS WHEREOF, we have hereto set our hands and seals this 21st day orr December 2022 R Dependable Const Inc Principal/Contractor By: President Kct�yil`adilla The Ohio Casualty Insurance Company Surety By: Attorney-irot Ashley N. Baker PAYMENT BOND - 2 STATE OF CALIFORNIA COUNTY OF ) ss. On this day of , in the year , before nte, a Notary Public in and for said state, personally appeared , known to nie (or proved to be on the basis of satisfactory evidence) to he the person whose name is subscribed to the within instrument as the Attorney -in -Fact of the (surety) and acknowledged to me that be subscribed the name of the (surety) thereto and his own name as Attorney -in -Fact. (SEAL) My Commission Expires ATTACHED Notary Public in and for said State PAYMENT BOND-3 CERTIFICATE AS TO CORPORATE PRINCIPAL I, Rosemary Padilla , certify that I am the Corporate Secretary of the corporation named as principal in the attached bond, that Rosemary Padilla who signed the said bond on behalf of the principal was then President of said corporation; that I know his signature, and his signature thereto is genuine; and that said bond was duly signed, sealed and attested for and in behalf of said corporation by authority of its governing Board. (Corporate Seal) Signature 12/22/2022 Date NOTE: A copy of the power of attorney to local representatives of the bonding company may be attached hereto. PAYMENT BOND - 4 CALIFORNIA ALL-PURPOSE CERTIFICATE OF ACKNOWLEDGMENT A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of San Bernardino On �G I before me, Beatriz A. Corona -Torres (Here insert name and title of the officer) personally appeared Padilla who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. Signature of Notary Public �> BEATRIZA.CORONA•TORRES " Notary Public • Californla c Riverside County Commisslon N 2321354 (Notary Seal a„ 0 h y Comm. Expires Feb 13, 2024 ADDITIONAL OPTIONAL INFORMATION DESCRIPTION OF THE ATTACHED DOCUMENT (Title or description of attached document) (Title or description of attached document continued) Number of Pages Document Date p-1 2.Z Z (Additional information) CAPACITY CLAIMED BY THE SIGNER ❑ Individual (s) ❑ Corporate Officer (Title) ❑ Partner(s) ❑ Attorney -in -Fact ❑ Trustee(s) ❑ Other INSTRUCTIONS FOR COMPLETING THIS FORM Any acknowledgment completed in California mast contain verbiage exactly as appears above in the notary section or a separate acknowledgment form must be properly completed and attached to that document The only exception is if a document is to be recorded outside of California. In such instances, anv alternative acknowledgment verbiage as may be printed on such a document so long as the verbiage does not require the notary to do something that is illegal for a notary in California (i.e. certifying the authorized capacity of the signer). please check the document carefully for proper notarial wording and attach this form tf required. • State and County information must be the State and County where the document signer(s) personally appeared before the notary public for acknowledgment. • Date of notarization must be the date that the signer(s) personally appeared which must also be the same date the acknowledgment is completed. • The notary public must print his or her name as it appears within his or her commission followed by a comma and then your title (notary public). • Print the name(s) of document signer(s) who personally appear at the time of notarization. • Indicate the correct singular or plural forms by crossing off incorrect forms (i.e. he/she/they, is law ) or circling the correct forms. Failure to correctly indicate this information may lead to rejection of document recording. • The notary seal impression must be clear and photographically reproducible. Impression must not cover text or lines. If seal impression smudges, re -seal if a sufficient area permits, otherwise complete a different acknowledgment forth. • Signature of the notary public must match the signature on file with the office of the county clerk. Additional information is not required but could help to ensure this acknowledgment is not misused or attached to a different document. Indicate title or type of attached document, number of pages and date. Indicate the capacity claimed by the signer. If the claimed capacity is a corporate officer, indicate the title (i.e. CEO, CFO, Secretary). • Securely attach this document to the signed document 2008 Version CAPA vl2.10.07 800-873-9865 www.NotaryClasses.com This Power of Attorney limits the acts of those named herein, and they have no authority to bind the Company except in the manner and to the extent herein stated. Liberty Mutual. SURETY Liberty Mutual Insurance Company The Ohio Casualty Insurance Company West American Insurance Company POWER OF ATTORNEY Certificate No: 8208023.987721 KNOWN ALL PERSONS BY THESE PRESENTS: That The Ohio Casualty Insurance Company is a corporation duly organized under the laws of the Slate of New Hampshire, that Liberty Mutual Insurance Company is a corporation duty organized under the laws of the State of Massachusetts, and West American Insurance Company is a corporation duly organized under the laws of the Slate of Indiana (herein collectively called the 'Companies ), pursuant to and by authority herein set forth, does hereby name, constitute and appoint, Ashley N. Baker, Karen A. Eby, Kyle T. Baker, Timothy C. Baker all of the city of Murrieta state of CA each individually it there be more than one named, its true and lawful attorney -in -fact to make, execute, seal, acknowledge and deliver, for and on its behalf as surely and as its act and deed, any and all undertakings, bonds, recognizances and other surety obligations, in pursuance of these presents and shall be as binding upon the Companies as if they have been duly signed by the president and attested by the secretary of the Companies in their own proper persons. IN WITNESS WHEREOF, this Power of Attorney has been subscribed by an authorized officer or official of the Companies and the corporate seals of the Companies have been affixed therelothis Ilth day of May , 2022 . Liberty Mutual Insurance Conpany PV INSU/.� PVZY INSU 0\NSUw� The Ohio Casualty Insurance Company J onvory y J oepOW uP ore°°qq ti West American Insurance Company o r� °� 9 o rpa Z� 3° r� Om P Y g � � m ru 1912 ° ° 1919 1997 ° rs �(y`, o :p eo e o ~dpl9mBACNUS',aD$ s° rywANPS�,aD� Ye, rw°IANP ,aD; �1�1 9jy w f,0 dH1 • xN dM F� By: n.� rx cnro„ e«ia.m so..omN rn County of MONTGOMERY ss On this Ilth dayof May 2022 before me personally appeared David M.Carey, who acknowledged himself to be the Assistant Secretary of Liberty Mutual Insurance 5 Company, The Ohio Casualty Company, and West American Insurance Company, and that he, as such, being authorized so to do, execute the foregoing instrument for the purposes therein contained by signing on behalf of the corporations by himself as a duly authorized officer. ra IN WITNESS WHEREOF, I have hereunto subscribed my name and affixed my notarial seal at King of Prussia, Pennsylvania, on the day and year first above written. e PA r Qx'r y°xW PC Camiwnvaallhol PaPems\ttivy Ndary Seal O N� ti� ri Y Teresa slela, N Pubrro r nF M1bnl� meaty MY Canravm mimbe2604Ma1By N ry�"✓ryyycv>,,c, nk,roar, rcm,2raxa,wooam„orxol,M: oesa Paslella, Notary Public m 4av ate'" ID This Power of Attorney is made and executed pursuant to and by authority of the following By-laws and Authorizations of The Ohio Casualty Insurance Company, Liberty Mutual Insurance Company, and West American Insurance Company which resolutions are now in full force and effect reading as follows: m ARTICLE IV —OFFICERS: Section 12. Power of Attorney. @ Any officer or other official of the Corporation authorized for that purpose in writing by the Chairman or the President, and subject to such limitation as the Chairman or the cc President may prescribe, shall appoint such altomeys-in-fact as may be necessary to act in behalf of the Corporation to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surely obligations. Such attorneys -in -fact, subject to the limitations set forth in their respective powers of attorney, shall t have full power to bind the Corporation by their signature and execution of any such instruments and to attach thereto the seal of the Corporation. When so executed, such instruments shall be as binding as if signed by the President and attested to by the Secretary. Any power or authodty granted to any representative or attorney -in -fact under the provisions of this article may be revoked at any time by the Board, the Chairman, the President a by the officer a officers granting such power a authority J ARTICLE XIII— Execution of Contracts: Section 5. Surely Bonds and Undertakings. Any officer of the Company authorized for that purpose in writing by the chairman or the president and subject to such limitations as the chairman or the president may prescribe, shall appoint such attorneys -in -fact, as may be necessary to act in behalf of the Company to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety obligations. Such altomeys-in-fact subject to the limitations set forth in their respective powers of attorney, shall have full power to bind the Company by their signature and execution of any such instruments and to attach thereto the seal of the Company. When so executed such instruments shall be as binding as if signed by the president and attested by the secretary. Certificate of Designation — The President of the Company, acting pursuant to the Bylaws of the Company, authorizes David M. Carey, Assistant Secretary to appoint such altomeys-in- fact as may be necessary to act on behalf of the Company to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety obligations. Authorization — By unanimous consent of the Companys Board of Directors, the Company consents that facsimile or mechanically reproduced signature of any assistant secretary of the Company, wherever appearing upon a certified copy of any power of attorney issued by the Company in connection with surety bonds, shall be valid and binding upon the Company with the same force and effect as though manually affixed. I, Renee C. Llewellyn, the undersigned, Assistant Secretary, The Ohio Casualty Insurance Company, Liberty Mutual Insurance Company, and West American Insurance Company do hereby cedily that the original power of attorney of which the foregoing is a full, true and correct copy of the Power of Attorney executed by said Companies, is in full face and effect and has not been revoked. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seals of said Companies this 21st day of December , 2022 . P� 1NSU7�P\,SY tNByr(9��45;9(0( 'PqIa°o�ORrrOy C+mayJa°°�ip°Wry Z�i�'11912 004 1919mo°a ay—dqe a�c*u. aa�yO y`°ANv+*aaD$ By. Renee C. Llewellyn, Assistant Secretary LMS-12873 LMIC OCIC WAIC Win Co OMI CALIFORNIA ALL- PURPOSE CERTIFICATE OF ACKNOWLEDGMENT A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of Riverside ) On '?% � before me, K. A. Eby, Notary Public (Mere 7M name an,t [ale UNIC e o ricer) personally appeared Ashley N. Baker who proved to me on the basis of satisfactory evidence to be the person whose na 1� �subscribed to the within instrument and acknowledged to me that s hey executed the same in tyi"eir authorized capacity(tsj, and that by �hi'6—eeiir signature�4 on the instrument the person'W, or the entity upon behalf of which the perso�sfacted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS y hand' not official seal. ^ , •. K. A. eeY ® COMM. N2333693 --y �' � •@ NOipBVPUBIKEpl1I011N1p � NNEPSIO(GOUNTY y Y Cemm. E.Plmakl(q,Bp y Ay. Notary Pub Signature (Notary Public Seal) AINSTRiJCTIONSFOR COMPLETTNGTHIS FORM ADDITIONAL OPTIONAL INFORMATION Thisform complies will, current California statates regarding notary wording mid, DESCRIPTION OF THE ATTACHED DOCUMENT (needed should be completed mid attached to the dociane nt. Acknowledgments from other states nary be completed for documents being sent to thin mate so long as the wading does nor require the Cattfmnia notary to violate Caltfarria notary lme. (Title or description of attached document) . Stale and County infonnatidn must be the Slate and County where the document signer(s) personally appeared before the notary public for acknowledgment. — . Dale of notarization must be the dale that the signer(s) personally appeared which (Title or description of attached document continued) must also be the same date the ad:nowledgmenl is completed. . 'The notary public must print his or her time as it appears within his or. her Number of Pages _Document Date commissimn followed by a comma and then your title (notary public). • Print the name(s) of document signer(s) who personally appear at die time of notarization. CAPACITY CLAIMED BY THE SIGNER • Indicate the correct singular or plural forms by crossing off incorrect forms (i.e. helshwihey,— is /aro) or circling the correct fools. Failure to corectly indicate Ibis ❑ Individual (s) Information may lead to rejectimn of document recording. ❑ Corporate Officer • The notary seal impression must be clear and photographically reproducible. Impression must not cover text or lines. If seal impression smudges, re -seal if a (Title) sufficient area permits, otherwise complete a different acknowledgment form. ❑ Partner(s) • Signature of the notary public must match the signature on file with the office of the county clak. ❑ Attorney -in -Fact . Additional information is not required but could help to ensure this ❑ Trustee(s) acknowledgment is not misused or attached to a different document. Other Indicate title or type of attached document, number of pages and dare. ❑ indicate the capacity claimed by the signer. If the claimed capacity is a ff d' corporate o rca, m kale the title (i.e. CEO, CFO, Secretary). -- , -... • Securely attach this document to the signed document with a staple. Request for Taxpayer Give Form to the Form V�Q Identification Number and Certification requester. Do not (Rev. October2018) Department of the Treasury send to the IRS. Internal Revenue Service Go to www.1rs.gov1FormW9 for instructions and the latest Information. 1 Name (as shown on your Income tax return). Name Is required on this line; do not leave this line blank. R DEPENDABLE CONST INC 2 Business nameldisregarded entity name, if different from above is 3 Check appropriate box for federal tax classification of the person whose name is entered on line 1. Check only one of the 4 Exemptions (codes apply only to following seven boxes. certain entities, not Individuals; see n Instructions on page 3): p ElIndividuaysole proprietor or ElC Corporation 08 Corporation ElPartnership ElTmsgestate c single -member LLC Exempt payee code Of any) 0 ❑ Dmited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=Partnership) ► p 2 Note: Check the appropriate box In the line above for the tax classification of the single -member owner. Do not check Exemption from FATCA reporting 7ii LLC if the LLC is classified as a single -member LLC that is disregarded from the owner unless the owner of the LLC is code Of any) M u another LLC that Is not disregarded from the owner for U.S. federal tax purposes. Otherwise, a single -member LLC that Is disregarded from the owner should check the appropriate box for the tax classification of Its owner. ❑ Other (see instructions)► I Poem:ro•R«ans,remrrt,.ao,rt ftU.S/ y5 Address (number, street, and apt. or suite no.) See Instructions. Requesters name and address (optional) 1019 W 3RD STREET, STE B 8 City, state, and ZIP code SAN BERNARDINO, CA. 92410 7 List amount numbers) here (optional) MIM Taxpayer Identification Number (TIN) Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid Social security number backup withholding. For individuals, this is generally your social security number (SSN. However, fora - m - resident alien, sole proprietor, or disregarded entity, see the instructions for Part I, later. For other entities, it is your employer Identification number (EIN). If you do not have a number, see How to get a TIN, later. or Note: If the account is In more than one name, see the instructions for line 1. Also see What Name and I Employer Identification number Number To Give the Requester for guidelines on whose number to enter. 2 7- 1 1 0 1 2 1 9 1 9 1 9 1 6 Under penalties of perjury, I certify that: 1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me); and 2. 1 am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all Interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding; and 3. 1 am a U.S. citizen or other U.S. person (defined below); and 4. The FATCA code(s) entered on this form Of any) indicating that I am exempt from FATCA reporting is correct. Certification Instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage Interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an Individual retirement arrangement (IRA), and generally, payments other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. See the instructions for Part 11, later. Her I Signature of �/A 1C1 �.ry /�!I l� / Here U.S. person► r�(-�/�( C� Daee► 12/22/2022 General Instructions Section references are to the Internal Revenue Code unless otherwise noted. Future developments. For the latest information about developments related to Form W-9 and its instructions, such as legislation enacted after they were published, go to www.irs.gov1FomrW9. Purpose of Form An Individual or entity (Form W-9 requester) who is required to file an Information return with the IRS must obtain your correct taxpayer identification number (TIN) which may be your social security number (SSN), individual taxpayer Identification number (iTIN), adoption taxpayer identification number (ATIN), or employer Identification number (EIN), to report on an Information return the amount paid to you, or other amount reportable on an Information return. Examples of Information returns Include, but are not limited to, the following. • Form 1099-INT (Interest earned or paid) • Form 1099-DIV (dividends, Including those from stocks or mutual funds) • Form 1099-MISC (various types of income, prizes, awards, or gross proceeds) • Form 1099-B (stock or mutual fund sales and certain other transactions by brokers) • Form 1099-S (proceeds from real estate transactions) • Form 1099-K (merchant card and third party network transactions) • Form 1098 (home mortgage interest), 1098-E (student loan Interest), 1098-T (tuition) • Form 1099-C (canceled debt) • Form 1099-A (acquisition or abandonment of secured property) Use Form W-9 only if you are a U.S. person (including a resident alien), to provide your correct TIN. If you do not return Form W-9 to the requester with a TIN, you might be subject to backup withholding. See What is backup withholding, later. Cat. No. 10231X Form W-V (Rev.10-2018) C�C4� STATE CONTRACTORS ICK SE BOARD ACTIVE LICENSE ....».. ,9440$$ .WCORP R DEPENDABLE CONST INC ja.ir uvµ.�B P 03/3112024 www.asib.aa.yov Contractor Information Legal Entity Name RDEPENDA13LECONSTINC Legal Entity Type Corporation Status Active Registration Number 1000002054 Registratlon effective date 7/112022 j Registration expiration data 6/30/2023 Meiling Address 1019 W 3RD STREET STE B SAN BERNARDINO 92410 CA United Ste... PhysicalAddress 1019 W 3RD STREET, STE B SAN BERNARDINO 92410 CA United Sta... Email Addross Dade Name/DBA License Number(s) CSL8:944088 CSL0:944088 Registration History Effective Date Expiration Date 6/812018 6/30/2019 6/12/2017 6/30/2018 6/10/2016 6130/2017 6/1912015 6/30/2010 10/21/2014 6/3012015 7/1/2019 6/30/2020 711/2020 6/30/2021 e 7/112022 6/3012023 State of California Secretary of State STATEMENT OF INFORMATION (Domestic Stock and Agricultural Cooperative Corporations) FEES (Filing and Disclosure); $26.00, If amendment, see Instructions. IMPORTANT • READ INSTRUCTIONS BEFORE COMPLETING THIS FORM FILED In the office of the Secretary of State of the State of California Sep . 30 2000 This Space For Filing Use Only 1. OORPORATE NAME (Please do not alter If name Is preprinted.) 03234199 R DEPENDABLE CONST INC, DUE DATE: COMPLETE ADDRESSES FOR THE FOLLOWING (Do not abbreviate the name of the City, items 2 and 3 cannot be P.O. Boxes. 2. STREETADDRESS OF PRINCIPAL EX90UTIVE OFFICE CITY STATE ZIP CODE 1019 W SRO ST STE B SAN BERNARDINO CA 92410 S. STREET ADDRESS OF PRINCIPAL BUSINESS OFFICE IN CALIFORNIA, IF ANY CITY STATE ZIP CODE 1019 W SRD ST STE B SAN BERNARDINO CA 02410 4. MAILING ADDRESS OPTHE CORPORATION, IF DIFFERENT THAN ITEM 2 CRY STATF, ZIP CODE NAMES AND COMPLETE ADDRESSES OF THE FOLLOWING OFFICERS (The corporaton must have these three officers, A comparable title for the specific officer may be added; however, the preprinted MISS on this farm must not be altered.) 6. CHIEF EXECUTIVE Opoew ADDRESS CITY STATE ZIP CODE ROSEMARY R PAPILLA 1019 W SRO ST STE B SAN BERNARDINO, CA 92410 6, SECRETARY/ . ADDRESS CITY STATE ZIP CODE ROSEMARY R PADILLA 1019 W 3RD ST STE B SAN BERNARDINO; CA 92410 7. CHIEF FINANCIALOFFICER/ ADDRESS—_� CITY STATE ZIP CODE ROSEMARY R PADILLA 1019 W 3RD ST STE B SAN BERNARDINO CA 92410 NAMES AND COMPLETE ADDRESSES OF ALL DIRECTORS, INCLUDING DIRECTORS WHO ARE ALSO OFFICERS (The corporation must have at least one director, Attach additional pages, If necessary.) _ e NAME ADDRESS CITY STATE ZIP CODE ROSEMARY R PADILLA 1019 W 3RD ST STE B SAN BERNARDINO, CA 92410 S. NAME fSDQRES9 CITY STATE ZIP CODE 10. NA19 d AbDRE99 CITY STATE ZIP CODE 11, NUMBER OF VACANCIES ON THE BOARD OF DIRECTIONS, IF ANY: AGENT FOR SERVICE OF PROCESS (If the agent Is an IndNidual, tha agent must reside In California and Item 13 must be completed %Ath a Callfamla street address (a P.O.Dox address Is not acceptable). If the agent is another corporation, the agent must have on file with the California Secretary of State a certificate pursuant to Corporations Cade section 1606 and Item 13 must be left blank) 12. NAME OF AOENT FOR SERVICE OF PROCESS ROSEMARY R PADILLA 13, STREET ADDRESS OF AGENT FOR SERVICE OF PROCESS IN CALIFORNIA, IF AN INDIVIDUAL CITY STATE ZIP CODE 1019 W 3RO ST STE'B SAN BARNARDINO, CA 92410 TYPE OF BUSINESS 14, DESCRIBE THE TYPE OF BUSINESS OF THE CORPORATION CONSTRUCTION ASSIST 16. aYSUBMITTINGTHIS STATEMENT OF INFORMATION TO THE CALIFORNIA SECRETARY OF STATE, THE CORPORATION CERTIFIES THE INFORMATION COWAINED HEREIN, INCLUOIW MY.ATT'ACHMENTB, IS TRUG AND CORRECT. 09/3012009 _ MARK ALLENTALCOTT PREpOFTAXES DATE TYPE OR PRINT NAME OF FERSCN COMPLE7IN0 THE FORM V I L . BIB— G, T�rCURG Sb200 C (REV 01@000) APPROVED BY SECRETARY OF STATE FILE[ " in the oh"of the Swrelary of Stala W tha Sfeto oP 0alitomla SEP 112009 The name of this corporetion Is R DEPENDABLE CONST INC. The purpose of the corporation Is to engage In any lawful act or activity for which a corporation may be organized under the GENERAL CORPORATION LAW of California other than the banking business, the trust company business or the practice of a profession permitted to be Incorporated by the California Corporations Code. The name and address In the State of California of tills corporation's initial agent for service of process is: Name; ROSEMARY R. PADILLA Address: 1019 W. 3R" ST STE #B City: SAN BERNARDINO. CA 92410 Ili This corporation is authorized to issue only one class of shares of stock; and the total number of shares which this corporation Is authorized to Issue Is 2000. Rosemary Padilla Phone: (951) 381-2310 Email: rdependable@gmaii.com rosemaryrpadilla@gmail.com Johnny Ruiz Phone: (951) 232-5872 Email: johnnyjruiz@gmail.com johnny@rdpconstinc.com Evelin Garay Phone: (909) 381-2310 Email: evelin@rdpconstinc.com Astrid Rabanales Phone: (909) 381-2310 Email: astrid@rdpconstinc.com Bettie Corona -Torres Phone: (909) 381-2310 Email: receivablespayables2022@gmaii.com Joe Padilla Phone: (951) 232-3394 Email: joerpadilla@gmail.com joe@rdpconstinc.com Elias Velasco Phone: (909) 381-2310 Email: estimatingl@rdpconstin.com estimating@rdpconstinc.com Damaris Lara Phone 909-381-2310 Email: estimating2@rdpconstinc.com Kindra Padilla Phone: (909) 381-2310 Email: kindra@rdpconstinc.com R DEPENDABLE CONST. INC Phone: (909) 381-2310 Email: rdependable@gmail.com Email: estimating@rdpconstinc.com